A randomized feasibility pilot trial of hearing treatment for reducing cognitive decline: Results from the Aging and Cognitive Health Evaluation in Elders Pilot Study

Abstract

IntroductionHearing loss (HL) is prevalent and independently related to cognitive decline and dementia. There has never been a randomized trial to test if HL treatment could reduce cognitive decline in older adults.MethodsA 40-person (aged 70–84 years) pilot study in Washington County, MD, was conducted. Participants were randomized 1:1 to a best practices hearing or successful aging intervention and followed for 6 months. clinicaltrials.gov Identifier: NCT02412254.ResultsThe Aging and Cognitive Health Evaluation in Elders Pilot (ACHIEVE-P) Study demonstrated feasibility in recruitment, retention, and implementation of interventions with no treatment-related adverse events. A clear efficacy signal of the hearing intervention was observed in perceived hearing handicap (mean of 0.11 to −1.29 standard deviation [SD] units; lower scores better) and memory (mean of −0.10 SD to 0.38 SD).DiscussionACHIEVE-P sets the stage for the full-scale ACHIEVE trial (N = 850, recruitment beginning November 2017), the first randomized trial to determine efficacy of a best practices hearing (vs. successful aging) intervention on reducing cognitive decline in older adults with HL.

Does Treating Hearing Loss in Older Adults Improve Cognitive Outcomes? A Review

“…Thus, long-term epidemiologic studies, although observational, may provide valuable knowledge, since the protective effects of hearing aid use may be hardly observable in clinical trials involving small samples of participants or a short-duration follow-up. Notably, the ongoing ACHIEVE study, a large trial on 850 older adults, will be the first randomized trial to determine the efficacy of a best-practices hearing intervention (compared to a successful aging intervention) on reducing cognitive decline in older adults with hearing loss [74]. Awaiting these results, and keeping in mind the previously mentioned caveats, the available data globally support the hypothesis that hearing aids' use positively impacts long-term cognition in older adults suffering from hearing loss, but definitely call for more research to ascertain such a statement and provide more information on the delay at which the benefits can be observable, the daily frequency of hearing aids use required, and many other questions that remain fully open.…”

Effects of hearing impairment and hearing aid use on the incidence of cognitive impairment among community-dwelling older adults: evidence from the Taiwan Longitudinal Study on Aging (TLSA)

“…Although the bene ts of hearing aids in regard to preventing cognitive impairments are not yet evident, these devices may still prevent social isolation and depression [10]. An ongoing randomized study, Aging and Cognitive Health Evaluation in Elders (ACHIEVE) trial, aims to determine e cacy of a best practices hearing (vs. successful aging) intervention on reducing cognitive decline in older adults with hearing loss [29]. Further trials are also needed to evaluate the cost-effectiveness of hearing aids in the dementia prevention and management contexts.…”

A systematic narrative synthesis of acute amplification-induced improvements in cognitive ability in hearing-impaired adults

“…In two of these cases, cognition was assessed using general dementia screening tools that provided little insight about the nature of cognition improvement (Acar et al 2011;Mulrow 1990). Six studies assessed cognitive function after three or more months of hearing-aid use (Acar et al 2011;Choi et al 2011;Deal et al 2017;Karawani, Jenkins, and Anderson 2018;Mulrow 1990;Zarenoe et al 2017), a considerable amount of time that is perhaps more relevant to long-term effects rather than momentary or acute effects.…”