BACKGROUND: Age-related hearing loss is common among older adults and may influence physical activity and sedentary behaviors, such as TV viewing. This study examined whether a hearing intervention could affect these behaviors over three years. METHODS: 977 participants (mean age of 76.8, 53.5% female, 11.5% Black), recruited from the ARIC study (n=238) and de novo (n=739) with hearing loss (pure-tone average=39.4 dB), were randomized to a hearing intervention or a health education control group. Physical activity, leisurely walking, and TV viewing were interrogated at baseline and three-year follow-up. We used regression models adjusted for demographic and hearing loss severity to examine the impact of the intervention on the change in the frequency of engaging in these activities. RESULTS: At baseline, 57.6% of participants engaged in moderate-to-vigorous physical activity (MVPA), 29.1% in high-frequency leisurely walking, and 46.8% in high-frequency TV viewing. Over three years, MVPA decreased to 48.8%, while leisurely walking and TV viewing increased. After three years, the hearing intervention group had similar odds of engaging in MVPA (ratio of odds ratios [ROR] = 1.03, 95% confidence interval [CI]: 0.93 to 1.14), leisurely walking (ROR = 1.04, 95% CI: 0.93 to 1.17), and TV viewing (ROR = 0.95, 95% CI: 0.87 to 1.02) compared to the control group. Results were consistent across recruitment sources (ARIC and de novo). CONCLUSION: A hearing intervention did not significantly influence physical activity, walking, or TV viewing behaviors in older adults over three years. Additional strategies may be needed to change physical and sedentary behaviors in this population.