OBJECTIVES: Hearing loss is a prevalent factor contributing to reduced quality of life and has been linked to various comorbidities, with potential significant implications for psychosocial and cognitive health. The aim of this study was to give current information about the prevalence of hearing loss, loneliness and depression, and to examine the association between these. STUDY DESIGN: Cohort study. METHODS: The Gutenberg Health Study, a large representative cohort study for the general population, was initiated in 2007 at the University Medical Center Mainz, Germany. Hearing loss was assessed using pure-tone audiometry, with severity graduated in percentages according to the World Health Organization (WHO). Loneliness and depressive symptoms were assessed using self-report measures: Loneliness Scale (≥2) for loneliness and the PHQ-9 (≥10) for depressive symptoms. RESULTS: Among 5,948 participants (25-86 years), the prevalence of hearing loss was 38.7%. Loneliness was reported by 9.5% of the participants and the prevalence of significant symptoms of depression was 9.9%. The risk of loneliness was found to be significantly higher in participants with severe to complete hearing loss (OR = 3.92, p = 0.011). In addition, the odds ratio (OR) for depressive symptoms was significantly higher in those with a mild to severe hearing loss compared to those with normal hearing (OR = 1.3
p = 0.025). There was no association with hearing aid use. CONCLUSION: Hearing loss is associated with both loneliness and depressive symptoms. Longitudinal studies are required to clarify the causal relationships and to further investigate the direct impact of early hearing aid fitting on the progression of loneliness and depression. LEVEL OF EVIDENCE: 2 Laryngoscope, 2025.