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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 FR, Pike JR, Albert MS, Arnold M, Burgard S, Chisolm T, Couper D, Deal JA et al.. Lancet (London, England), 2023-07-18
Topic: Risk, prevention and care in population studies
Background Hearing loss is associated with increased cognitive decline and incident dementia in older adults. In the primary analysis combining the ARIC and de novo cohorts, 3-year cognitive change (in SD units) was not significantly different between the hearing intervention and health education control groups (-0·200 [95% CI -0·256 to -0·144] in the hearing intervention group and -0·202 [-0·258 to -0·145] in the control group; difference 0·002 [-0·077 to 0·081]; p=0·96). However, a prespecified sensitivity analysis showed a significant difference in the effect of the hearing intervention on 3-year cognitive change between the ARIC and de novo cohorts (p interaction =0·010). Other prespecified sensitivity analyses that varied analytical parameters used in the total cohort did not change the observed results. No significant adverse events attributed to the study were reported with either the hearing intervention or health education control. However, a prespecified sensitivity analysis showed that the effect differed between the two study populations that comprised the cohort. These findings suggest that a hearing intervention might reduce cognitive change over 3 years in populations of older adults at increased risk for cognitive decline but not in populations at decreased risk for cognitive decline.
Key findings
- Background Hearing loss is associated with increased cognitive decline and incident dementia in older adults.
- In the primary analysis combining the ARIC and de novo cohorts, 3-year cognitive change (in SD units) was not significantly different between the hearing intervention and health education control groups (-0·200 [95% CI -0·256 to -0·144] in the hearing intervention group and -0·202 [-0·258 to -0·145] in the control group; difference 0·002 [-0·077 to 0·081]; p=0·96).
- However, a prespecified sensitivity analysis showed a significant difference in the effect of the hearing intervention on 3-year cognitive change between the ARIC and de novo cohorts (p interaction =0·010).
- Other prespecified sensitivity analyses that varied analytical parameters used in the total cohort did not change the observed results.
- No significant adverse events attributed to the study were reported with either the hearing intervention or health education control.
Why it matters
In this US randomised trial of older adults with hearing loss, a hearing intervention did not change 3-year cognitive decline compared with a health education control: both groups declined by about 0·2 SD (difference 0·002, p=0·96), and no significant study-related adverse events were reported in either group. A prespecified sensitivity analysis found the effect differed between the trial's two cohorts (ARIC and de novo; p interaction =0·010), which the authors say suggests a hearing intervention "might" reduce cognitive change in older adults at increased risk of decline. That is a secondary signal, not a shown benefit.
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Study details
- Study designrandomized controlled trial
- Participants858
- Evidence strengthHigh
How this study scored 84/100
Published in a top-tier journal, and it is a randomised controlled trial. Scored zero for effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 10 / 10 | Tier 1 — top-tier general journal (Lancet (London, England)) |
| Journal's citation record | 4 / 4 | The Lancet: journal h-index 1,205 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 2 / 4 | 858 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 6 / 7 | Cited 469 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 93.8 citations a year over 5 year(s) since 2023 |
| Impact for its field and year | 6 / 6 | Cited 65.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 27 other studies in this library |
| Still being cited | 4 / 4 | Cited 447 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Josef Coresh: h-index 193 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Johns Hopkins University: institution h-index 2,306 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 12 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 37478886) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 84 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Lin, F. R., Pike, JR., Albert, M. S., Arnold, M., Burgard, S., Chisolm, T., et al. (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 (London, England). https://doi.org/10.1016/s0140-6736(23)01406-x
Vancouver
Lin FR, Pike JR, Albert MS, Arnold M, Burgard S, Chisolm T, et al. 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 (London, England). 2023. doi:10.1016/s0140-6736(23)01406-x. PMID: 37478886.
BibTeX
@article{lin2023-37478886,
author = {Lin, F. R. and Pike, JR. and Albert, M. S. and Arnold, M. and Burgard, S. and Chisolm, T. and Couper, D. and Deal, J. A. and others},
title = {{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}},
journal = {Lancet (London, England)},
year = {2023},
doi = {10.1016/s0140-6736(23)01406-x},
pmid = {37478886},
url = {https://doi.org/10.1016/s0140-6736(23)01406-x}
}
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