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Hearing Aids Slow Risk of Cognitive Decline in Older Adults

Hearing Well Matters! (Burlington)

New results from the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study found that hearing intervention slowed cognitive decline in older adults with mild to moderate hearing loss by 48%.

The ACHIEVE Study is the largest randomized, controlled clinical trial of hearing aids for reducing long-term cognitive decline in older adults. The results were reported for the first time on July 18 at the Alzheimer’s Association International Conference 2023, and published in The Lancet.

The ACHIEVE study is a randomized trial of older adults aged 70-84 with untreated hearing loss who were free from substantial cognitive impairment. There were 977 total participants recruited from two study populations: 238 adults participating in the Atherosclerosis Risk in Communities (ARIC) study, and 739 healthy community volunteers newly recruited to the study.

At the start of the trial, all study participants generally had mild to moderate hearing loss very typical of older adults, but no substantial cognitive impairment. The three-year intervention included use of hearing aids, a hearing tool kit to assist with self-management, and ongoing instruction and counseling with an audiologist. The comparison group health education control group had talk sessions with a health educator about chronic disease prevention. 

The most interesting result was the comparison of the ARIC subgroup hearing intervention versus control, in which a 48% slowing of cognitive decline was observed. The researchers noted that the participants from the ARIC study had more risk factors for cognitive decline, lower baseline cognitive scores, and a faster rate of three-year cognitive decline during the study than the others.

“The positive results with the hearing intervention in the ARIC subgroup analysis are encouraging and warrant further investigation,” says Maria Carrillo, PhD, Alzheimer’s Association chief science officer. “Previous research has identified hearing loss as potentially the single largest dementia risk factor that can be addressed or modified.”

“The hearing intervention had a significant effect on reducing cognitive change within three years in the population of older adults in the study who are at increased risk for cognitive decline,” said Frank Lin, MD, PhD, of Johns Hopkins University, and co-primary investigator of the ACHIEVE study. “Hearing loss is very treatable in later life, which makes it an important public health target to reduce risk of cognitive decline and dementia, along with other dementia risk factors such as less education in early life, high blood pressure, social isolation and physical inactivity.”

Findings from the ACHIEVE study suggest that older adults at increased risk for cognitive decline and dementia who also have hearing loss may benefit the most from this hearing intervention within three years. According to the ACHIEVE researchers, the hearing intervention may slow down decline in thinking and memory by making listening easier for the brain, or by helping people remain more socially and physically active.

“In both groups, we also found that the hearing intervention improved communication abilities, social functioning and loneliness,” Lin says. “Until we know more, we recommend for general health and well-being that older adults have their hearing checked regularly and any hearing issues properly addressed.”

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