Artikel
Improved hearing along with evidence of cognitive resilience: Results from the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study
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Autoren
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Victoria A. Sanchez
- University of South Florida, Tampa, USA
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Frank R. Lin
- ACHIEVE Collaborative Research Group, USA
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James R. Pike
- ACHIEVE Collaborative Research Group, USA
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Marilyn S. Albert
- ACHIEVE Collaborative Research Group, USA
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Michelle L. Arnold
- ACHIEVE Collaborative Research Group, USA
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Sheila Burgard
- ACHIEVE Collaborative Research Group, USA
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Theresa H. Chisolm
- ACHIEVE Collaborative Research Group, USA
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David Couper
- ACHIEVE Collaborative Research Group, USA
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Jennifer A. Deal
- ACHIEVE Collaborative Research Group, USA
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Adele M. Goman
- ACHIEVE Collaborative Research Group, USA
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Nancy W. Glynn
- ACHIEVE Collaborative Research Group, USA
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Theresa Gmelin
- ACHIEVE Collaborative Research Group, USA
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Lisa Gravens-Mueller
- ACHIEVE Collaborative Research Group, USA
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Kathleen M. Hayden
- ACHIEVE Collaborative Research Group, USA
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Alison R. Huang
- ACHIEVE Collaborative Research Group, USA
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David Knopman
- ACHIEVE Collaborative Research Group, USA
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Christine M. Mitchell
- ACHIEVE Collaborative Research Group, USA
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Thomas Mosley
- ACHIEVE Collaborative Research Group, USA
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Haley N. Neil
- ACHIEVE Collaborative Research Group, USA
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James S. Pankow
- ACHIEVE Collaborative Research Group, USA
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Nicholas S. Reed
- ACHIEVE Collaborative Research Group, USA
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Jennifer A. Schrack
- ACHIEVE Collaborative Research Group, USA
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B. Gwen Windham
- ACHIEVE Collaborative Research Group, USA
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Josef Coresh
- ACHIEVE Collaborative Research Group, USA
| Veröffentlicht: | 5. März 2024 |
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Gliederung
Text
Hearing loss is highly prevalent among older adults and independently associated with cognitive decline. The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study is a multicenter randomized control trial (Clinicaltrials.gov NCT03243422; NIH funded R01AG055426), designed to determine the efficacy of best-practices hearing intervention, versus a successful aging education control intervention, on 3-year trajectory of cognitive decline in older adults. Participants were recruited from two study populations at each of 4 study sites in the U.S., including adults from a long-standing observational study of cardiovascular health (the Atherosclerosis Risk in Communities [ARIC] study), and healthy volunteers recruited de novo from the community. We enrolled 977 older adults without substantial cognitive impairment at baseline with mild-to-moderate untreated hearing loss. Randomization was 1:1 and each intervention consisted of 4 initial sessions, with semiannual booster sessions for 3 years. The hearing intervention was standardized yet personalized. Using the intention-to-treat analysis, the primary endpoint was 3-year change in a global cognition.
Overall, 54% of participants were female and 88% were self-reported White race. Mean age was 76.8±4.0 years. Compared to the de novo cohort, participants from ARIC were older, had more risk factors for cognitive decline (e.g., lower educational attainment, more likely to live alone, higher proportion with diabetes), and had lower cognitive scores at baseline. In the primary analysis, hearing intervention did not reduce 3-year cognitive decline (difference comparing hearing intervention to control: 0.002 standard deviation units [95% confidence interval (CI): -0.077 to 0.081]; p=0.96). In a prespecified sensitivity analysis, the hearing intervention reduced 3-year cognitive change in the ARIC cohort by 48% (difference comparing intervention to control: 0.191 SD [95% CI: 0.022 to 0.360]; p=0.027), but not in the de novo cohort (p-interaction=0.010). Although hearing intervention did not reduce 3-year cognitive decline in the total cohort, a significant reduction was seen in older adults at increased risk of cognitive decline. Additional results indicated hearing intervention improved communicative function, reduced cortical thinning, and positively impacted social health and well-being.
