Have Self-Reported Hearing Aid Outcomes Improved? A Comparison of Clinical Cohorts Across a Decade

Background: Despite advances in hearing aid (HA) technology and improved financial accessibility, it remains unclear whether these changes have translated into greater real-world HA use and satisfaction, and reduced concerns related to stigma. The current study aimed to compare HA use patterns and satisfaction among adults fitted with HAs in 2012 versus 2025.

Methods: Participants were adults with mild-to-severe hearing loss and ≥6 months of HA experience. Two cohorts were compared, 2025 (n=194) versus 2012 (n=131). Outcomes included prevalence of HA use/non-use, daily hours of use, reasons for non-use, and self-reported Satisfaction with Amplification in Daily Life (SADL) questionnaire scores. Cohort differences were evaluated using univariate analyses and multivariable regression adjusted for demographic/clinical characteristics.

Results: HA use increased modestly from 83% to 88% , while daily hours of use increased significantly (p<.0001). While Global SADL scores did not differ between cohorts, the 2025 cohort reported greater satisfaction with service and cost (p<.001), and fewer complaints regarding background noise, feedback, and telephone use (p=.01). However, concerns related to personal image and stigma increased (p<.001), while perceived functional benefit and sound quality remained unchanged. Limited perceived benefit and difficulty hearing in noise remained the leading reasons for non-use.

Conclusions: Over more than a decade, HA use became more consistent and satisfaction improved in selected domains, while overall use and global satisfaction remained largely unchanged. Further improvements in hearing care should address persistent barriers to HA use, and concerns related to self-image and stigma.