Evidence map›Paper›PMID 37478886›Full record

Trial reportLancet (London, England)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.

Frank R Lin, James R Pike, Marilyn S Albert, Michelle Arnold, Sheila Burgard, Theresa Chisolm, David Couper, Jennifer A Deal, Adele M Goman, Nancy W Glynn and 14 more

2 registry-linked trialsOpen access · greenAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Lancet (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 274 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
274citing papers in PubMed, 5 pooled it
82.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03243422 nacompletednot on this map

Aging and Cognitive Health Evaluation in Elders (ACHIEVE) Randomized Trial

TypeinterventionalSponsorJohns Hopkins Bloomberg School of Public HealthRan2018 to 2023Enrolled977ConditionsAging, Cognitive DeclineArmsSuccessful aging health education intervention, Hearing intervention
NCT06495268 naactive not recruitingnot on this mapstarted 2024, after this paper: background citation

Healthy Hearing for Healthy Ageing: a Proof-of-concept Randomized Controlled Trial of Data-driven Hearing Rehabilitation Versus Standard Care in Older Adults With Hearing Impairment.

TypeinterventionalSponsorKuopio University HospitalRan2024 to 2028Enrolled200ConditionsSensorineural Hearing Loss, Cognitive DeclineArmsIndividualised data-driven hearing rehabilitation, Standard care hearing rehabilitation
3 · Its place in the literature

Who cites it

274 citing papers in PubMed, 5 syntheses or guidelines pooled it, 372 citations in OpenAlex.

  1. Complications of Cochlear Implant Surgery in Low- and Middle-Income Countries: A Systematic Review.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026
    Pooled it
  2. Hearing aids for mild to moderate hearing loss in adults.The Cochrane database of systematic reviews · 2026
    Pooled it
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  5. Dual sensory impairment: Global prevalence, future projections, and its association with cognitive decline.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
    Pooled it
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  20. Effect of Hearing Intervention Versus Health Education Control on Fatigue: A Secondary Analysis of the ACHIEVE Study.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024
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214 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

24 authors at 10 institutions in 2 countries.

Frank R LinDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA; Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA. Electronic address: flin1@jh.edu.
James R PikeDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Marilyn S AlbertDepartment of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Michelle ArnoldDepartment of Communication Sciences & Disorders, College of Behavioral & Community Sciences, University of South Florida, Tampa, FL, USA.
Sheila BurgardDepartment of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
Theresa ChisolmDepartment of Communication Sciences & Disorders, College of Behavioral & Community Sciences, University of South Florida, Tampa, FL, USA.
David CouperDepartment of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
Jennifer A DealDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Adele M GomanSchool of Health and Social Care, Edinburgh Napier University, Edinburgh, UK.
Nancy W GlynnDepartment of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.
Theresa GmelinDepartment of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA.
Lisa Gravens-MuellerDepartment of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
Kathleen M HaydenDepartment of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Alison R HuangDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
David KnopmanDepartment of Neurology, Mayo Clinic, Rochester, MN, USA.
Christine M MitchellDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Thomas MosleyThe MIND Center, University of Mississippi Medical Center, Jackson, MS, USA.
James S PankowDivision of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA.
Nicholas S ReedDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Otolaryngology-Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Victoria SanchezDepartment of Otolaryngology-Head & Neck Surgery, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
Jennifer A SchrackDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA.
B Gwen WindhamThe MIND Center, University of Mississippi Medical Center, Jackson, MS, USA.
Josef CoreshDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
ACHIEVE Collaborative Research Group
Johns Hopkins University · USUniversity of North Carolina at Chapel Hill · USUniversity of South Florida · USUniversity of Mississippi Medical Center · USUniversity of Pittsburgh · USEdinburgh Napier University · GBJohns Hopkins Medicine · USMayo Clinic in Arizona · USUniversity of Minnesota · USWake Forest University · US

Funding

ARIC Neurocognitive Study (ARIC-NCS) Renewal 2023-2028U01HL096812 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI JOSEF CORESH, THOMAS H MOSLEY · 2010 to 2026
$65.7M
Aging, Cognition, and Hearing Evaluation in Elders (ACHIEVE) Randomized TrialR01AG055426 · NIA · JOHNS HOPKINS UNIVERSITY · PI CORESH, JOSEF, LIN, FRANK R · 2017 to 2021
$16.6M
ARIC Neurocognitive Study (ARIC-NCS) Renewal 2 of 5U01HL096917 · NHLBI · UNIVERSITY OF MISSISSIPPI MED CTR · PI MOSLEY, THOMAS H · 2010 to 2018
$11.9M
ARIC Neurocognitive Study (ARIC-NCS) Renewal UNC 4 of 5U01HL096899 · NHLBI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI COUPER, DAVID J · 2010 to 2018
$7.5M
ARIC Neurocognitive Study (ARIC-NCS)U01HL096902 · NHLBI · UNIVERSITY OF MINNESOTA · PI LUTSEY, PAMELA L. · 2010 to 2018
$7.4M
ARIC Neurocognitive Study (ARIC-NCS) Renewal 4 of 5U01HL096814 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI HUGHES, TIMOTHY M., WAGENKNECHT, LYNNE E · 2010 to 2018
$6.5M
TRAINING IN THE EPIDEMIOLOGY OF AGINGT32AG000181 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI STROTMEYER, ELSA S. · 1989 to 2025
$6.2M
The ARIC and Neurocognitive Longitudinal StudyR01HL070825 · NHLBI · UNIVERSITY OF MISSISSIPPI MEDICAL CENTER · PI MOSLEY, THOMAS H · 2002 to 2004
$5.1M
Hearing loss, brain aging, and speech-in-noise performance in the ACHIEVE studyR01AG060502 · NIA · JOHNS HOPKINS UNIVERSITY · PI LIN, FRANK R · 2018 to 2022
$3.2M
Planning a trial of hearing rehabilitative treatment to reduce cognitive declineR34AG046548 · NIA · JOHNS HOPKINS UNIVERSITY · PI CORESH, JOSEF, LIN, FRANK R · 2014 to 2015
$626k
NHLBI NIH HHS HHSN268201700001CNHLBI NIH HHS HHSN268201700001INHLBI NIH HHS HHSN268201700002CNHLBI NIH HHS HHSN268201700002INHLBI NIH HHS HHSN268201700003CNHLBI NIH HHS HHSN268201700003INHLBI NIH HHS HHSN268201700004CNHLBI NIH HHS HHSN268201700004INHLBI NIH HHS HHSN268201700005CNHLBI NIH HHS HHSN268201700005INHLBI NIH HHS R01 HL070825NHLBI NIH HHS U01 HL096812NHLBI NIH HHS U01 HL096814NHLBI NIH HHS U01 HL096899NHLBI NIH HHS U01 HL096902NHLBI NIH HHS U01 HL096917NIA NIH HHS R01 AG055426NIA NIH HHS R01 AG060502NIA NIH HHS R34 AG046548NIA NIH HHS T32 AG000181
6 · The paper itself

Abstract

backgroundHearing loss is associated with increased cognitive decline and incident dementia in older adults. We aimed to investigate whether a hearing intervention could reduce cognitive decline in cognitively healthy older adults with hearing loss.

methodsThe ACHIEVE study is a multicentre, parallel-group, unmasked, randomised controlled trial of adults aged 70-84 years with untreated hearing loss and without substantial cognitive impairment that took place at four community study sites across the USA. Participants were recruited from two study populations at each site: (1) older adults participating in a long-standing observational study of cardiovascular health (Atherosclerosis Risk in Communities [ARIC] study), and (2) healthy de novo community volunteers. Participants were randomly assigned (1:1) to a hearing intervention (audiological counselling and provision of hearing aids) or a control intervention of health education (individual sessions with a health educator covering topics on chronic disease prevention) and followed up every 6 months. The primary endpoint was 3-year change in a global cognition standardised factor score from a comprehensive neurocognitive battery. Analysis was by intention to treat. This trial was registered at ClinicalTrials.gov, NCT03243422.

findingsFrom Nov 9, 2017, to Oct 25, 2019, we screened 3004 participants for eligibility and randomly assigned 977 (32·5%; 238 [24%] from ARIC and 739 [76%] de novo). We randomly assigned 490 (50%) to the hearing intervention and 487 (50%) to the health education control. The cohort had a mean age of 76·8 years (SD 4·0), 523 (54%) were female, 454 (46%) were male, and most were White (n=858 [88%]). Participants from ARIC were older, had more risk factors for cognitive decline, and had lower baseline cognitive scores than those in the de novo cohort. 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

interpretationThe hearing intervention did not reduce 3-year cognitive decline in the primary analysis of the total cohort. 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.

fundingUS National Institutes of Health.

Indexed as

AtherosclerosisCognitive DysfunctionHearing LossAgedCognitionFemaleHealth EducationHearingHumansMale

Identifiers

PMID37478886
PMCPMC10529382
OpenAlexW4384701165

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.