Seek hearing assessment and suitable hearing aids for better communication, without relying on a promise of dementia prevention

Hearing aids can cost thousands to tens of thousands of RMB in China and are often paid out of pocket. Fitting and several adjustment visits may be needed.

ACHIEVE enrolled 977 adults aged 70–84 in four US communities with untreated hearing loss and no substantial cognitive impairment. Participants were randomized to hearing counseling plus aids or a health-education control and followed every six months. The primary endpoint was three-year change in global cognition. In the combined population, changes were −0.200, 95% CI −0.256 to −0.144, versus −0.202, −0.258 to −0.145; the difference was 0.002, −0.077 to 0.081, P=0.96. A prespecified sensitivity analysis found different effects between the two recruitment populations, interaction P=0.010. Participants from the long-running cardiovascular cohort were older, had more cognitive-risk factors, and lower initial cognitive scores. The authors concluded that intervention might reduce three-year cognitive change in higher-risk people but not in the lower-risk group. No serious study-attributed adverse events were reported.

Disputed interpretation: claims that hearing aids nearly halved cognitive decline refer to a subgroup, not the primary overall result. Separate the present benefits of hearing support from a universal prevention claim. Hearing-related examination accommodations are in entry 13; relevant driving requirements are in entry 15.

Lin FR, Pike JR, Albert MS et al.; ACHIEVE Collaborative Research Group (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. Lancet, 402(10404), 786–797. https://doi.org/10.1016/S0140-6736(23)01406-X