Study Shows Hearing Aids May Reduce the Risk of Cognitive Decline in At-Risk Patients

Among an aging population, cognitive decline is probably one of the most dreaded diagnoses possible. After all, dementia not only impacts an individual’s ability to enjoy and participate in life, but it threatens one’s independence.

Over the past few years, researchers have found more and more connections between hearing loss and cognitive decline, but the real question has been whether hearing aids could help prevent it?

Now, a new study presented at the 2023 Academy of Doctors of Audiology conference showed game-changing results for those who wear professionally fitted hearing aids.

This three-year trial was called the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study. The study was a three-year randomized trial that found hearing aids and hearing treatment reduced the risk of cognitive decline and dementia for people in half, while also reducing the risk of loneliness and depression.

ACHIEVE has been heralded as a landmark study for both doctors and growing numbers of aging adults concerned with the onset of cognitive decline and dementia.

According to the researchers, led by Frank Lin, MD, PhD, of Johns Hopkins, in 2050, about 1 in 30 people will be living with dementia. Although this represents a large patient population, it also suggests that dementia isn’t an extremely common consequence of aging. Not everyone experiences rapid cognitive decline, and some things have been shown to buffer the risk of developing dementia.

In the ACHIEVE study, nearly 1,000 older adults ages 70-84 with untreated mild-to-moderate hearing loss and normal cognitive function participated. These individuals came from two distinct groups: 739 community volunteers were recruited by ads and online. These people were mentally active, health-conscious, and motivated enough to volunteer and commit to a long-term clinical trial focused on ways to promote healthy aging.

A second group of 238 people were already enrolled in the Atherosclerosis Risk in Communities (ARIC) study. These individuals had been monitored for their cardiovascular problems since 1987 and were at greater risk for cognitive decline and dementia. They had very different health profiles from the first group.

All participants were told the trial involved two types of interventions: 1) general health education and 2) treatment using hearing aids and audiological care at regular intervals from an audiologist who used a well-defined “best practices” protocol. They would be randomly assigned to one intervention type and offered the other after 3 years.

At the end of 3 years (which included the 2020 pandemic), an impressive 90% of the study participants returned for follow-up testing. People who were assigned to wear hearing aids actually wore them for an average of 7 hours a day and had a high level of satisfaction.

Interestingly, the participants who had atherosclerosis and received hearing aids showed a large (48%) reduction in overall cognitive decline after only 3 years. For this group who were at greater risk for cognitive decline, the intervention program made a huge difference in their rate of cognitive decline. However, in the healthy group, there was no difference in the cognitive scores between those who received hearing aids or the health education program.

The data showed the so-called healthy individuals had a very slow rate of cognitive change. In fact, their mental functioning was very similar at the beginning and end of the study, leading the researchers to conclude that there wasn’t much to slow down for this health-conscious group. But, in the less healthy group, hearing aids made a big difference.

In addition, it’s important to note that in both participant groups, hearing aids were found to improve communication abilities and social functioning while reducing loneliness.

More research is needed to determine actual hearing aid treatment recommendations for those at risk for cognitive decline, but this study points to a future where more doctors may individualize treatment recommendations based on the person’s health history, communication goals, cognitive status, and risk factors.

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