Study Finds a 92 Percent Unmet Need for Hearing Aids in India

A nationally representative study of 31,902 older adults in India finds that fewer than 8 percent of those who need hearing aids actually use one, the widest gap for any assistive device examined.

Glasses, hearing aids, canes, and walkers are among the simplest health technologies in existence, and among the most unevenly used. For older adults, these devices can be the difference between independence and isolation, yet in much of the world they never reach the people who need them.

A new analysis of one of the largest aging studies ever conducted in India puts hard numbers on that gap, and the starkest number belongs to hearing.

Background: Why the Researchers Looked at This

Functional limitations in hearing, vision, and mobility are among the most common health problems of later life, and each has a well-established assistive technology: hearing aids, glasses, and mobility aids such as canes and walkers. When people who need a device do not have one, researchers call it unmet need.

Unmet need matters beyond inconvenience. Untreated sensory and mobility limitations are linked to depression, reduced independence in activities of daily living, and social withdrawal. Yet nationally representative evidence from India, home to one of the world's largest and fastest-growing older populations, has been limited.

The authors set out to measure, across the whole country, how many older adults use each type of device, how many go without, and how device use relates to daily functioning and depressive symptoms.

How the Study Was Done

The researchers analyzed Wave 1 of the Longitudinal Ageing Study in India (LASI), collected in 2017 and 2018. Their sample included 31,902 adults aged 60 years and older, weighted to represent the national older population.

For each domain, they identified people reporting the relevant difficulty, then calculated what share used an assistive device and what share had unmet need. They then used survey-adjusted logistic regression to test associations between device use and two outcomes: severe limitation in activities of daily living, defined as three or more limitations, and depressive symptoms, defined as a score of 4 or higher on a standard screening scale.

What the Researchers Found

The three devices told three very different stories. Vision care was the clear success: among older adults with vision difficulties, 91.8 percent used glasses or another vision device, leaving unmet need at just 8.2 percent.

Mobility aids lagged far behind. Only 12.2 percent of older adults with mobility difficulties used a cane, walker, or similar aid, an unmet need of 87.8 percent.

Hearing came last. Among older adults with hearing difficulties, only 7.8 percent used a hearing aid. The remaining 92.2 percent, more than nine in ten, had unmet need, the largest gap of any device category in the study.

Device use also tracked with daily functioning, though not always in the expected direction. Vision device use was associated with lower odds of severe limitation in activities of daily living. Mobility aid use was associated with higher odds of severe limitation, a pattern the authors attribute to reverse causation: people with the most severe limitations are the ones who acquire canes and walkers in the first place. Sensitivity analyses found no significant association between mobility aid use and depressive symptoms.

What It Means for People with Hearing Loss

The comparison with glasses is the study's most telling result. Glasses are inexpensive, sold nearly everywhere, socially normalized, and require little ongoing professional service. Hearing aids, in most of the world, are none of those things: they have traditionally been costly, distributed through specialist clinics, and dogged by stigma. The result is a 92 percent gap in India for hearing versus an 8 percent gap for vision.

While the study is Indian, the pattern is global. Research in high-income countries has repeatedly found that most adults who could benefit from hearing aids do not use them, with cost and access among the leading reasons. The authors' conclusion, that equitable access to affordable assistive technology should be a policy priority, applies well beyond one country's borders.

A 92 Percent Gap: Why Lowering the Cost Barrier Matters

Because this study highlights how cost and service barriers keep hearing aids out of reach, it is worth noting that newer FDA-OTC hearing aids in the United States were created to lower exactly those barriers, letting adults with mild-to-moderate hearing loss buy a device directly. Panda Air is one such device, a modern earbud-style hearing aid with 16-channel WDRC processing and multi-band adaptive noise reduction.

Air takes the self-fitting OTC hearing aid approach: an optional app can run a frequency-specific hearing test through the aid itself and personalize gain and frequency response to the user's hearing profile, and the aid also works out of the box without the app or the test. As a rechargeable hearing aid with a charging case, its fast-charge case provides 60 hours of total use, and it streams calls, TV, and music over Bluetooth.

Air carries a 5-year warranty and a 45-day trial that begins when the customer receives the product. The usual caveat applies: over-the-counter devices are approved for mild-to-moderate hearing loss, and severe or profound loss still benefits most from clinical fittings.

Limitations of This Research

The analysis draws on a single wave of data, so it captures a snapshot rather than change over time, and both difficulties and device use were self-reported rather than clinically measured. The counterintuitive mobility aid findings underline how confounding by indication can complicate this kind of observational work, a limitation the authors acknowledge directly.

The data were also collected in 2017 and 2018, so more recent shifts in India's health programs and device markets are not reflected.

What to Do With This

A 92 percent unmet need is not a technology problem, since hearing aids exist and work, but a delivery problem of cost, distribution, and stigma, and the study's glasses-versus-hearing-aids contrast shows how completely those barriers can fall when a device becomes cheap, available, and ordinary.

Roy A, Das B. Seeing, hearing, and moving: Inequalities in assistive device use and health outcomes among older adults in India. Assistive Technology. 2026. Retrieved from PubMed. https://doi.org/10.1080/10400435.2026.2711815