People living in residential aged care are far less likely to use hearing aids or receive regular hearing examinations than elderly people living at home, new research shows.
The study, published in the Australasian Journal on Ageing in November 2025, is one of the biggest analyses of vision and hearing in patients in New Zealand.
The researchers analysed about 50,000 interRAI assessments conducted nationwide between January 2019 and December 2020. The cohort comprised older adults receiving home support or living in aged residential care facilities (mean age 82, 65% female).
The InterRAI, a global network of researchers and practitioners committed to improving care for people who are disabled or medically complex, strives to promote evidence-informed clinical practice and policy decision-making.
The researchers said most (about 80%) in their study reported adequate or only minimally impaired hearing but the low uptake of hearing aids among those with significant impairment was a concern.
Key findings:
- Nearly one in five (19%) experienced moderate to severe hearing difficulty.
- There was a staggering disparity in device use. While 72% of residents in aged residential care facilities wore visual aids (glasses) only 20% used hearing aids .
- Access to regular testing dropped significantly when seniors moved into care. About 31% of those living at home had had a hearing examination within the past two years, compared with just 21% of those in residential care facilities.
- 7% met criteria for dual sensory impairment (in vision and hearing), which is linked to higher risks of loneliness, cognitive decline, and loss of independence.
Lead author, University of Otago ophthalmology consultant, Dr Francesc March de Ribot, said hearing impairment affects communication, social engagement, overall well-being and increases dementia risk.
“Similar to Australia, there was a lack of eye examinations, especially in rest homes, and a significant gap in examinations and hearing aids for Māori and Pasifika,” he told HPA.
“Only 20% of those residing in aged residential care facilities reported using hearing aids, suggesting a substantial gap between need and uptake. This discrepancy highlights a persistent challenge in recognising hearing loss, accessing diagnostic services, and adopting appropriate interventions among older New Zealanders.”
Dr March de Ribot said the decline in assessments for institutionalised older adults raised important questions about access, prioritisation of sensory health in care environments, and potential barriers.
“Reduced assessments mean reduced opportunities for early identification and intervention, which could otherwise prevent functional decline, social withdrawal, and communication difficulties,” he said.
“Improving access to hearing assessments and increasing awareness of the benefits of hearing rehabilitation are essential steps.”
He said the data was likely comparable to reality among older adults in Australian aged residential care facilities. Dr March de Ribot plans to do further research in Australia following the interest
Hearing aid use in the community
“Australia has studied the prevalence of hearing aids in the community, finding that 69% of people with moderate or worse bilateral hearing impairment used a hearing aid. In our study, we found use of 42-46%,” he said.
“Australia determined that one-third of people in this age group with significant hearing loss don’t use hearing aids; it was more than half in our study.”
He said the team highlighted that while vision services appeared well-integrated into aged care, evidenced by the high use of glasses, hearing health was lagging.
The study also pointed to a need for targeted health policies that encouraged wider distribution of hearing services and improved access for certain ethnic groups or groups with limited resources.
The researchers said findings strengthened the case for a more proactive approach to hearing screenings in care facilities, ensuring that auditory health was treated with the same clinical priority as vision.
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