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

Lin, Frank R.; Pike, James R; Albert, Marilyn; Arnold, Michelle; Burgard, Sheila; Chisolm, Theresa H.; Couper, David J.; Deal, Jennifer A.; Goman, Adele M.; Glynn, Nancy W.; Gmelin, Theresa; Gravens-Mueller, Lisa; Hayden, Kathleen M.; Huang, Alison; Knopman, David S.; Mitchell, Christine; Mosley, Thomas H.; Pankow, James S.; Reed, Nicholas; Sánchez, Victoria; Schrack, Jennifer A.; Windham, B. Gwen; Coresh, Josef

doi:10.1016/s0140-6736(23)01406-x

Cited by 112 publications

(81 citation statements)

References 25 publications

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“…Future studies with comprehensive assessments of socialization and mood are needed to interrogate this association further. With the recent positive clinical trial showing that hearing aids reduced cognitive decline in those at increased risk for dementia, 49 our studies highlight the need to examine sex‐specific mechanisms for dementia risk and risk reduction via hearing interventions.…”

Section: Discussionmentioning

confidence: 98%

Women with hearing loss show increased dementia risk and brain atrophy

Fitzhugh,

2023

Alz & Dem Diag Ass & Dis Mo

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Hearing loss is a modifiable risk factor for dementia. However, it is unknown whether risk differs by sex.Study 1 used Cox proportional hazard models to examine sex differences in the association between hearing loss (measured by speech‐reception thresholds) and dementia risk. Study 2 examined how 2‐year changes in hearing is associated with changes in brain volume in auditory–limbic regions. Both studies used UK Biobank data.Women with poor hearing had the greatest risk of dementia, whereas women and men with insufficient hearing were at similar risk. Men with poor hearing did not have increased risk. Presence of social isolation/depressed mood minimally contributed to dementia risk in men and women. Women, but not men, with hearing loss had greater atrophy in auditory and limbic regions compared to normal hearing women and men.Women with hearing loss show greater risk of dementia and brain atrophy, highlighting the need to examine sex‐specific mechanisms.

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Section: Discussionmentioning

confidence: 98%

Women with hearing loss show increased dementia risk and brain atrophy

Fitzhugh,

2023

Alz & Dem Diag Ass & Dis Mo

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“…Although the exact mechanism of association between VI, HI, perception", "sensory deprivation", and "common cause". 16,49 These hypotheses are not mutually exclusive but overlapping. Our research results indicate that MCR and sensory impairments are commonly present in CHARLS, and there is an interaction between HI and VI, further confirming the complex internal relationship between them.…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14] Sensory impairments consist of hearing impairment (HI), vision impairment (VI), and dual sensory impairment (DSI), which may be the most significant potential modifiable risk factors for cognitive complaints and pathological impairments, including incident dementia. 11, [15][16][17][18] The Lancet found that hearing intervention will effectively improve cognitive deterioration in older people within 3 years. 16 Stevenson et al 19 included 82,039 participants from the UK's Biobank and found that HI increases the risk of dementia by 91%.…”

Section: Introductionmentioning

confidence: 99%

“…11, [15][16][17][18] The Lancet found that hearing intervention will effectively improve cognitive deterioration in older people within 3 years. 16 Stevenson et al 19 included 82,039 participants from the UK's Biobank and found that HI increases the risk of dementia by 91%. The cascade theory and common cause theory provide a possible explanation for why s sensory impairment affects cognitive impairment and dementia.…”

Section: Introductionmentioning

confidence: 99%

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Associations of visual, hearing, and dual sensory impairment with motoric cognitive risk syndrome: Observational and Mendelian randomization analyses

Liang,

Zheng

et al. 2024

Int J Geriat Psychiatry

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BackgroundDementia is associated with individual vision impairment (VI) and hearing impairment (HI). However, little is known about their associations with motoric cognitive risk syndrome (MCR), a pre‐dementia stage. We investigated the association of VI, HI, and dual sensory impairment (DSI) with MCR and to further evaluate causal relationships using Mendelian randomization (MR) approach.MethodsFirst, an observational study was conducted in the China Health and Retirement Longitudinal Study (CHARLS). Evaluate the cross‐sectional and longitudinal associations of VI, HI, and DSI with MCR using the logistic regression models and Cox proportional hazard models, respectively. Second, evaluate the causal association between VI and HI with MCR using MR analysis. The GWAS data was used for genetic instruments, including 88,250 of European ancestry (43,877 cases and 44,373 controls) and 504,307 with “white British” ancestry (100,234 cases and 404,073 controls), respectively; MCR information was obtained from the GWAS with 22,593 individuals. Inverse variance weighted was the primary method and sensitivity analysis was used to evaluate the robustness of MR methods.ResultsIn the observational study, VI (HR: 1.767, 95%CI: 1.331–2.346; p < 0.001), HI (HR: 1.461, 95%CI: 1.196–1.783; p < 0.001), and DSI (HR: 1.507, 95%CI: 1.245–1.823; p < 0.001) were significantly associated with increased risk of MCR. For the MR, no causal relationship between VI (OR: 0.902, 95% CI: 0.593–1.372; p = 0.631) and HI (OR: 1.016, 95% CI: 0.989–1.043; p = 0.248) with MCR risk, which is consistent with the sensitivity analysis.ConclusionVI, HI, and DSI were significantly associated with MCR, but MR analysis failed to provide evidence of their causal relationship. Emphasized the importance of sensory impairment screening in identifying high‐risk populations for dementia.

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“…How is this relevant to messages about preventing dementia? The recently released Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study provides the first randomized clinical trial evidence about the short-term (3-year) efficacy of providing hearing aids on improving cognitive outcomes among older people (mean age, 76.8 years) with hearing loss (mean 4-frequency PTA [pure tone average], 39.4 dB). The treatment group was offered hearing aids along with audiological counseling every 6 months, and the control groups received a health education intervention for a total of 4 visits after randomization.…”

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confidence: 99%