# Long-term effects of hearing intervention on brain health in the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) randomized study

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2024 · $3,930,675

## Abstract

Novel approaches to reduce the risk of cognitive decline and Alzheimer's disease and related dementias (ADRD)
in older adults are urgently needed given the aging of the population. Over the past decade, observational
research has implicated peripheral hearing loss as being one of the largest potentially modifiable risk factors for
dementia that may account for 8-9% of all dementia cases. Hypothesized pathways underlying this observed
association may be modifiable with hearing loss treatment consisting of the use of hearing technologies (e.g.,
hearing aids) and rehabilitative training. The Aging & Cognitive Health Evaluation in Elders (ACHIEVE) study is
an ongoing, NIA-sponsored Phase III RCT (R01AG055426, MPIs: Lin/Coresh) investigating whether hearing
loss treatment versus an aging education control intervention reduces cognitive decline over a three-year follow-
up period. From 2018-19, we recruited 977 adults ages 70-84 with untreated mild-to-moderate hearing loss who
were randomized 1:1 at baseline (Year 0) to receive hearing intervention (HI; best-practice hearing services and
technologies) versus a successful aging (SA) education control intervention (i.e., one-on-one sessions with a
health educator covering topics important for healthy aging). Participants are currently being followed
semiannually at the ACHIEVE field sites with final Year 3 study visits scheduled from 2021-22. After their Year 3
visit, all participants randomized to the SA education control group will also be offered the hearing intervention.
Final Year 3 results from this original trial will indicate whether hearing intervention (versus a successful aging
control intervention) reduces cognitive decline over a 3-year interval after randomization. We now propose to
continue following the ACHIEVE cohort for an additional 3 years (i.e., up to Year 6) to determine the long-
term effects of hearing intervention (i.e., participants randomized to HI at Year 0) versus successful
aging/delayed HI control (i.e., participants randomized to SA at Year 0 and offered HI after their Year 3
visit) on cognitive and brain outcomes. Given that cognitive impairment typically reflects the slow
accumulation of pathologic changes, the benefits of HI in slowing this decline may not be fully appreciable within
just 3 years. Therefore, this 6-year follow-up of the cohort will allow us to fully evaluate the longer, cumulative
impact of HI on older adults. Such findings will complement the main trial results in 2023 and directly inform
clinical and policy decisions around the potential use of hearing interventions to reduce the risk of ADRD. This
proposed study has the following aims: Aim 1 To determine the long-term effect of HI versus SA/Delayed HI
control on rates of the co-primary outcomes of: (a) cognitive decline and (b) incident mild cognitive impairment
(MCI)/dementia. Aim 2 To determine the long-term effect of HI versus SA/Delayed HI control on changes in
brain MRI measures of: (a) regional...

## Key facts

- **NIH application ID:** 10893386
- **Project number:** 5R01AG076518-03
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** JOSEF CORESH
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $3,930,675
- **Award type:** 5
- **Project period:** 2022-08-15 → 2027-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10893386

## Citation

> US National Institutes of Health, RePORTER application 10893386, Long-term effects of hearing intervention on brain health in the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) randomized study (5R01AG076518-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10893386. Licensed CC0.

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