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Cited by 481Hearing Loss and RehabilitationDementia and Cognitive Impairment ResearchHearing, Cochlea, Tinnitus, Genetics

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

Open access
Lin, Frank R, Pike, James R, Albert, Marilyn S, Arnold, Michelle, Burgard, Sheila, Chisolm, Theresa, Couper, David, Deal, Jennifer A +15 more·2023·The Lancet
DOI 10.1016/s0140-6736(23)01406-xPMC PMC10529382
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Abstract

Background Hearing loss is associated with increased cognitive decline and incident dementia in older adults. We aimed to investigate whether a hearing intervention could reduce cognitive decline in cognitively healthy older adults with hearing loss. Methods The ACHIEVE study is a multicentre, parallel-group, unmasked, randomised controlled trial of adults aged 70-84 years with untreated hearing loss and without substantial cognitive impairment that took place at four community study sites across the USA. Participants were recruited from two study populations at each site: (1) older adults participating in a long-standing observational study of cardiovascular health (Atherosclerosis Risk in Communities [ARIC] study), and (2) healthy de novo community volunteers. Participants were randomly assigned (1:1) to a hearing intervention (audiological counselling and provision of hearing aids) or a control intervention of health education (individual sessions with a health educator covering topics on chronic disease prevention) and followed up every 6 months. The primary endpoint was 3-year change in a global cognition standardised factor score from a comprehensive neurocognitive battery. Analysis was by intention to treat. This trial was registered at ClinicalTrials.gov, NCT03243422. Findings From Nov 9, 2017, to Oct 25, 2019, we screened 3004 participants for eligibility and randomly assigned 977 (32·5%; 238 [24%] from ARIC and 739 [76%] de novo). We randomly assigned 490 (50%) to t…

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  • In the ACHIEVE study, hearing aids had no overall effect on cognition at three years, but a pre-specified analysis found a substantial effect in the ARIC subgroup.

    “There was no overall effect on the primary outcome, cognition at three-year follow-up (difference -0·002, -0·08 -0·08). Importantly, a pre-specified analysis found substantial effects in the ARIC subgroup in cognition at three years, (difference 0·19, 0·02 -0·36).”

    From Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission (2024) · cites this paper as [100]

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Authors
Lin, F. R., Pike, J. R., Albert, M. S., Arnold, M., Burgard, S., Chisolm, T., Couper, D., Deal, J. A., Goman, A. M., Glynn, N. W., Gmelin, T., Gravens-Mueller, L., Hayden, K. M., Huang, A. R., Knopman, D., Mitchell, C. M., Mosley, T., Pankow, J. S., Reed, N. S., Sanchez, V., Schrack, J. A., Windham, B. G., & Coresh, J.
Affiliations
  • Johns Hopkins University (US)
  • University of South Florida (US)
  • University of North Carolina at Chapel Hill (US)
  • Edinburgh Napier University (GB)
  • University of Pittsburgh (US)
  • Wake Forest University Health Sciences (US)
  • Mayo Clinic (US)
  • University of Mississippi Medical Center (US)
  • University of Minnesota (US)
Corresponding author
Lin, Frank R
ORCID
Venue
The Lancet
Publisher
Elsevier BV
Published
2023-09
Volume
402
Issue
10404
Pages
786-797
ISSN
  • 0099-5355 (ISSN-L)
  • 0140-6736
DOI
10.1016/s0140-6736(23)01406-x
PMC
PMC10529382
OpenAlex
W4384701165
Cited by
481
References
4
Citations by year
2026: 151 · 2025: 165 · 2024: 143 · 2023: 21 · 2022: 1
FWCI
71.60
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet (acceptedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion, cc-by-nc-sa)
  • Edinburgh Napier Research Repository (Edinburgh Napier University) (submittedVersion)
Funders
  • National Institute on Deafness and Other Communication Disorders (2U01HL096917, 2U01HL096899, R01HL70825, 2U01HL096814, 2U01HL096812, 2U01HL096902)
  • National Institute on Aging (R01AG055426, R01AG060502, R34AG046548)
  • National Institute of Neurological Disorders and Stroke
  • Harvard University
  • National Institutes of Health
  • University of Utah
  • Johns Hopkins University
  • University of California, San Diego
  • National Heart, Lung, and Blood Institute (HHSN268201700005I)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Hearing Loss and Rehabilitation
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Life Sciences › Neuroscience › Sensory Systems › Hearing, Cochlea, Tinnitus, Genetics
Keywords
hearing loss, cognitive decline, hearing aids, health education, older adults, dementia risk, neurocognitive function, Atherosclerosis Risk in Communities Study, ACHIEVE trial, untreated hearing loss, community-dwelling older adults, cardiovascular risk factors, chronic disease prevention
MeSH terms
Aged, Cognition, Female, Health Education, Hearing, Humans, Male, Hearing Loss, Atherosclerosis, Cognitive Dysfunction

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