Age-related hearing loss is a common disorder with important consequences for quality of life. We performed a systematic review of the evidence investigating the effect of age-related hearing loss on cognition and quality of life in the elderly, and evaluated the effect of interventions for hearing loss. There is a large body of evidence associating hearing loss with detriment to physical and mental health, cognition, independence, social interaction and quality of life in the elderly. Hearing rehabilitation programmes, hearing aids and cochlear implants show beneficial effects in restoring communicative ability in this group and subsequently improve quality of life. Furthermore, much of the benefit seen is comparable to that in younger adults. However, both identifying those at need of such interventions and implementing them effectively are sub-optimal. Treatment approaches that better address the difficulties within this group need to be developed and the role significant others have to play in hearing rehabilitation should be explored.