About

The goal of the ACHIEVE study is to learn if treating hearing loss in older adults reduces the loss of thinking and memory abilities (cognitive decline) that can occur with aging.

The study also looks at the effects of hearing intervention on other health outcomes, including cognitive impairment and dementia, brain structure and function, mental health and well-being, physical function, and health care use. 

The ACHIEVE study enrolled 977 adults aged 70-84 years old from 2018-2019. To join the study, participants had to: 

• Have untreated hearing loss
• Live in the community
• Have normal cognition 
• Be fluent in English

Participants in the ACHIEVE study came from two distinct study populations: a group of adults who were already participating in a heart health study and a group of healthy volunteers who were newly recruited from the community. The 238 participants who came from the heart health study were, on average, older and had more risk factors for cognitive decline than the 739 new healthy community volunteers.

Participants in the ACHIEVE study came from two distinct study populations: a group of adults who were already participating in a heart health study and a group of healthy volunteers who were newly recruited from the community. The 238 participants who came from the heart health study were, on average, older and had more risk factors for cognitive decline than the 739 new healthy community volunteers. 

When both groups of participants were analyzed together, the hearing intervention was not better than the health education control on slowing declines in thinking and memory abilities, at the end of the 3-year study.

When both groups of participants were analyzed separately, researchers found that the effect of hearing intervention differed significantly between the two groups of participants. 

In older adults at increased risk for cognitive decline, hearing intervention slowed down loss of thinking and memory abilities by 48% over 3 years. 

Hearing intervention benefited the heart health study participants the most. These participants were older and had more risk factors for cognitive decline. In this group, the hearing intervention reduced cognitive change by 48% over 3 years. 

In the newly recruited healthy volunteer group, hearing intervention had no effect on reducing cognitive decline within 3 years.

The world’s population is aging rapidly, and the number of older adults with dementia is increasing as well. Identifying prevention strategies that can be used to reduce the population-level risks of dementia is an urgent priority for governments around the world.

Hearing loss is among the important risk factors for cognitive decline and dementia that could be potentially addressed to help reduce dementia. Hearing loss is treatable in later life, which makes it an important public health target for dementia/cognitive decline prevention efforts. 

At the beginning of the study, participants were randomly assigned to a hearing intervention or to a health education control intervention.

The hearing intervention involved sessions with an audiologist and learning how to use hearing aids and other technologies to hear and communicate optimally. The health education control involved individual sessions with a health educator where participants learned about a variety of health topic areas relevant to older adults, and how to actively “take charge” of their health and well-being.

Participants completed four intervention sessions over three months with either the study audiologist or health educator. Participants then completed semi-annual study visits for the next three years.  Study visits included tests of thinking and memory, using testing procedures that ensure that hearing loss would not affect the accuracy of cognitive testing. Researchers also tested physical function and interviewed participants to assess mental health and well-being.

Participants in both groups received the same amount of attention from study personnel during the study.

After three years, participants were offered the other intervention - for example, participants who received the control intervention were offered the hearing intervention, and vice versa.

Learn More About Study Interventions

This research effort is led by Frank Lin, MD, PhD and Josef Coresh, MD, PhD at the Johns Hopkins Bloomberg School of Public Health. 

Participants were enrolled at four research sites across the U.S.: 

• Wake Forest University in Forsyth County, NC
• University of Mississippi Medical Center in Jackson, MS
• University of Minnesota in Minneapolis, MN
• Johns Hopkins University Comstock Center in Washington County, MD

Other academic centers were involved in designing and implementing the ACHIEVE study:

• University of South Florida – Designed the hearing intervention 
• University of Pittsburgh – Designed the health education control intervention 
• University of North Carolina at Chapel Hill - Data coordinating center 
• The Mayo Clinic – Brain MRI reading center

Learn More About Our Team

The ACHIEVE study (ClinicalTrials.gov identifier: NCT03243422) has been funded by grant # R01AG055426, R01AG060502, and R34AG046548 from the National Institute on Aging, part of the National Institutes of Health. Hearing aids and related technologies provided to participants in the study were donated in-kind by Sonova under a material transfer agreement with Johns Hopkins University.