Publications by Year: 2017

INTRODUCTION: Hearing loss (HL) is prevalent and independently related to cognitive decline and dementia. There has never been a randomized trial to test if HL treatment could reduce cognitive decline in older adults.

METHODS: A 40-person (aged 70-84 years) pilot study in Washington County, MD, was conducted. Participants were randomized 1:1 to a best practices hearing or successful aging intervention and followed for 6 months. clinicaltrials.gov Identifier: NCT02412254.

RESULTS: The Aging and Cognitive Health Evaluation in Elders Pilot (ACHIEVE-P) Study demonstrated feasibility in recruitment, retention, and implementation of interventions with no treatment-related adverse events. A clear efficacy signal of the hearing intervention was observed in perceived hearing handicap (mean of 0.11 to -1.29 standard deviation [SD] units; lower scores better) and memory (mean of -0.10 SD to 0.38 SD).

DISCUSSION: ACHIEVE-P sets the stage for the full-scale ACHIEVE trial (N = 850, recruitment beginning November 2017), the first randomized trial to determine efficacy of a best practices hearing (vs. successful aging) intervention on reducing cognitive decline in older adults with HL.

Age-related hearing loss affects nearly thirty million older adults in the United States and is associated with increased risk of several other adverse health outcomes. Although hearing aids are the most common efficacious treatment, Medicaid coverage of the aids is not federally mandated, and cost has been cited as a barrier to access. In this first (to our knowledge) comprehensive review of state-level Medicaid coverage of hearing aids and associated services for age-related hearing loss, we found that twenty-eight states offer some degree of coverage-which varies substantially with respect to extent and hearing loss eligibility requirements. Based on six criteria, we rated those states' coverage as fair, good, or excellent. The remaining twenty-two states have no coverage, which leaves few options for their residents with hearing loss who face financial constraints. Policy makers at the state and federal levels should consider how to make care for age-related hearing loss more accessible, affordable, and equitable nationwide.

INTRODUCTION: Hearing loss (HL) is prevalent and independently related to cognitive decline and dementia. There has never been a randomized trial to test if HL treatment could reduce cognitive decline in older adults.

METHODS: A 40-person (aged 70-84 years) pilot study in Washington County, MD, was conducted. Participants were randomized 1:1 to a best practices hearing or successful aging intervention and followed for 6 months. clinicaltrials.gov Identifier: NCT02412254.

RESULTS: The Aging and Cognitive Health Evaluation in Elders Pilot (ACHIEVE-P) Study demonstrated feasibility in recruitment, retention, and implementation of interventions with no treatment-related adverse events. A clear efficacy signal of the hearing intervention was observed in perceived hearing handicap (mean of 0.11 to -1.29 standard deviation [SD] units; lower scores better) and memory (mean of -0.10 SD to 0.38 SD).

DISCUSSION: ACHIEVE-P sets the stage for the full-scale ACHIEVE trial (N = 850, recruitment beginning November 2017), the first randomized trial to determine efficacy of a best practices hearing (vs. successful aging) intervention on reducing cognitive decline in older adults with HL.