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Bilateral hearing aids provide significantly higher APHAB benefit than unilateral aids in age-related hearing lossBilateral hearing aids provide more benefit for age related hearing loss

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Key Takeaway
Note that bilateral hearing aids provide statistically higher self-reported benefit than unilateral aids in age-related hearing loss.

This single-blinded parallel-group randomized clinical trial enrolled 275 individuals aged 50 years or older with age-related hearing loss and less than 3 months of prior hearing aid use. The study compared bilateral commercially available prescription receiver-in-the-canal hearing aids against unilateral commercially available prescription receiver-in-the-canal hearing aids over a 3-month follow-up period.

The primary outcome was the Abbreviated Profile of Hearing Aid Benefit (APHAB) score. The bilateral group (n=139) reported a mean score of 19.74 (15.18), while the unilateral group (n=136) reported a mean score of 14.41 (13.02). The bilateral group showed a significantly higher benefit compared to the unilateral group with a mean difference of -5.29% (95% CI, -8.79% to -1.80%).

Safety data, including adverse events and discontinuations, were not reported. A primary limitation is that it is not clear if the difference between the two groups reaches the threshold for clinical meaningfulness. While bilateral hearing aids yield greater self-reported benefit, both configurations produced individually meaningful improvements. These results inform clinical decisions but do not yet establish a standard-of-practice recommendation.

How this fits prior evidence

How this fits prior evidence: This study addresses a gap in clinical management for age-related hearing loss by comparing hearing aid configurations. While prior coverage identified ferroptosis as a key mechanism in acquired sensorineural hearing loss, this trial focuses on the clinical utility of bilateral versus unilateral hardware. The finding that bilateral aids provide a statistically significant higher benefit than unilateral aids (mean difference of -5.29%) adds to the evidence regarding patient-reported outcomes in hearing aid selection.

If you have trouble hearing in a crowded room or during a conversation, the choice of how to wear your hearing aids matters. A study of 275 people over age 50 looked at how much benefit patients felt when using hearing aids in both ears versus just one.

Researchers found that those using hearing aids in both ears reported a higher level of benefit than those using only one. While both groups saw improvements in their ability to hear, the group with bilateral devices reported a higher score on a standard benefit scale.

It is important to note that while the difference between the two groups was clear, it is not yet certain if the gap is large enough to change standard medical advice. Both setups provided meaningful improvements for the patients involved, but the best choice for your specific needs remains a conversation with your doctor.

What this means for you:
People using hearing aids in both ears reported more benefit than those using only one.

Common questions

Is it better to wear hearing aids in both ears?

People who used hearing aids in both ears reported a higher level of benefit than those who used only one. While both groups saw improvements, the bilateral group had a higher score on the benefit scale. You should talk to your doctor to see which setup is best for your specific hearing needs.

Who was included in this study?

The study included 275 people aged 50 years or older. These individuals had age related hearing loss and had used hearing aids for less than 3 months before the study began.

How much of an improvement did patients see?

The bilateral group reported a score of 19.74, while the unilateral group reported a score of 14.41. Both groups showed improvements, but the difference between the two groups is not yet confirmed to be large enough to change standard medical practice.

Study Details

Study typeRct
Sample sizen = 275
EvidenceLevel 2
Follow-up3.0 mo
PublishedOct 2026
View Original Abstract ↓
IMPORTANCE: Age-related hearing loss (ARHL) is ubiquitous and is characterized as bilateral symmetrical sensorineural and mild to moderate in degree. When left untreated, significant impacts arise in domains including communication, psychosocial, cognitive and physical health. Data demonstrating the effectiveness of unilateral or bilateral hearing aids (HAs) as the standard treatment are lacking. OBJECTIVE: To determine whether bilateral HAs provide more benefit compared with a unilateral HA. DESIGN, SETTING, AND PARTICIPANTS: This single-blinded parallel-group randomized clinical trial was conducted at audiology clinics at Duke University Health System and Vanderbilt University from 2021 to 2024 with the primary outcome duration of 3 months. Participants were aged 50 years or older with ARHL with less than 3 months of prior HA use seeking HAs. Participants were randomly assigned to the bilateral or unilateral group. Analyses were based on intention to treat. INTERVENTIONS: Commercially available prescription receiver-in-the-canal HAs. MAIN OUTCOMES AND MEASURES: The hypothesis was that bilateral HAs would provide greater benefit than a unilateral HA. The primary outcome was HA benefit as measured using the Abbreviated Profile of Hearing Aid Benefit (APHAB) score. Benefit was defined as the difference in APHAB-global score at the 3-month primary end point (aided) from baseline (pretreatment/unaided) APHAB scores. The primary analysis was a linear regression of the APHAB benefit score at 3 months with clinical site and hearing aid assignment as covariates. RESULTS: A total of 275 participants were included (148 female [53.8%]; mean [SD] age, 70.9 [7.9] years). The mean (SD) APHAB benefit score was 14.41 (13.02) for the unilateral group (n = 136) and 19.74 (15.18) for the bilateral group (n = 139). These results indicate that both groups had benefit as demonstrated in APHAB benefit scores, with the bilateral group experiencing significantly higher benefit compared with the unilateral group with a mean difference in APHAB benefit score of -5.29% (95% CI, -8.79% to -1.80%) between the groups. CONCLUSIONS AND RELEVANCE: The trial results indicate that bilateral HAs yield greater self-reported benefit than unilateral HAs; however, while statistically detectable, it is not clear whether this reaches the threshold for clinical meaningfulness. Both configurations produced individually meaningful improvements. These results inform, but do not yet establish, a standard-of-practice recommendation for bilateral fitting. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04739436.
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