Hearing aids fail to slow Cognitive Decline in high risk elderly individuals

A recent study, known as the ACHIEVE study published in the The Lancet has shed light on the connection between hearing loss and cognitive decline in older adults. The study by Frank Lin and team aimed to investigate whether a hearing intervention could mitigate cognitive decline in cognitively healthy older adults with untreated hearing loss.

Conducted at four community study sites across the USA, the ACHIEVE study was a multicentre, parallel-group, unmasked, randomised controlled trial targeting adults aged 70–84 years. The participants had untreated hearing loss but lacked substantial cognitive impairment. They were recruited from two distinct study populations: older adults participating in the long-standing observational study of cardiovascular health (Atherosclerosis Risk in Communities [ARIC] study) and healthy de novo community volunteers.

In the trial, the participants were randomly divided into two groups. The first group received a hearing intervention involving audiological counselling and provision of hearing aids. The second group, serving as the control, received health education with individual sessions covering topics on chronic disease prevention. The participants were monitored every six months, and the primary endpoint was the 3-year change in global cognition standardized factor scores from a comprehensive neurocognitive battery.

The results, published recently, revealed that 977 participants (32·5% of those screened) were assigned to the intervention. Among them, 50% received the hearing intervention, and the remaining 50% received health education as the control. The average age of the participants was 76·8 years, with a slight majority being female (54%) and most identifying as White (88%).

In the primary analysis of the entire cohort, the hearing intervention did not show a significant reduction in 3-year cognitive decline compared to the health education control. However, a prespecified sensitivity analysis indicated that the impact of the hearing intervention differed between the ARIC and de novo study populations. This finding suggests that the hearing intervention might be effective in reducing cognitive decline over three years in populations of older adults at higher risk for cognitive decline but not in those at lower risk.

Reference:

Lin, F. R., Pike, J. R., Albert, M. S., Arnold, M., Burgard, S., Chisolm, T., Couper, D., Deal, J. A., Goman, A. M., Gravens-Mueller, L., Mosley, T., Pankow, J. S., Reed, N. S., … Coresh, J. (2023). Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial. In The Lancet. Elsevier BV. https://doi.org/10.1016/s0140-6736(23)01406-x