Background <p>Hearing aids are the standard intervention for age‑related hearing loss; however, abandonment rates remain high, exposing individuals to the adverse consequences of untreated hearing loss. While prior studies have examined the effects of attitudes on hearing‑aid abandonment, evidence on how attitudes change over time and the factors associated with those changes is limited. Moreover, the impact of attitudinal change on abandonment remains unexplored. Our primary objective was to determine whether changes in attitudes toward hearing loss and hearing aids are associated with social (education level and social support) and clinical/individual factors (hearing self-perception and perceived social pressure). A secondary objective was to determine whether changes in attitudes predict hearing‑aid abandonment.</p> Methods <p>We conducted a prospective longitudinal study of older adults fitted with hearing aids at a public hospital within Chile’s public health system. Thirty‑one hearing‑aid users (both sexes) were reassessed 6 years after baseline. Hearing‑aid abandonment was determined by self‑report using a single item from the International Outcome Inventory for Hearing Aids (IOI‑HA). Attitudes toward hearing loss and hearing aids were measured at baseline and follow‑up using the Spanish version of the Attitudes towards Loss of Hearing Questionnaire (S‑ALHQ). Univariable and multivariable linear regression models were fitted to estimate predictors of change in these attitudes.</p> Results <p>The median S‑ALHQ score increased from 2.34 (25th–75th percentile: 2.05–2.50) at baseline to 2.45 (25th–75th percentile: 2.14–2.86) at follow-up. Multivariate analysis showed that a closer social network (i.e. social support) at baseline significantly predicted changes in attitudes toward hearing loss and hearing aids. Shifting toward negative attitudes was significantly associated with a higher risk of abandoning hearing aids (RR = 2.11; 95% CI, 1.32–3.35; <i>p</i> = 0.002). Additionally, a higher income level was associated with a decreased risk of abandonment (RR = 0.39; 95% CI, 0.21–0.73; <i>p</i> = 0.003).</p> Conclusions <p>Baseline social support was a significant predictor of changes in attitudes. Moreover, shifts towards more negative attitudes could predict device abandonment. Addressing the variables associated with shifts toward negative attitudes about hearing loss and hearing aids, especially those related to coping strategies, could reduce the number of older adults who abandon their hearing aids.</p>