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ACHIEVE Randomized Trial: Hearing Intervention to Delay Cognitive Decline

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1.  What are the primary findings of the ACHIEVE study? Overall, there was no effect of hearing treatment (vs. control) to reduce cognitive decline Overall, hearing treatment (vs. control) slowed decline in the domains of global function and language In a subset of participants, hearing treatment (vs. control) slowed decline in the domains of global function and language Both A & C

2.  Which of the following statements about the ACHIEVE study is true? Results definitively prove that hearing treatment prevents cognitive decline Results add to our understanding of the impact of hearing treatment to delay cognitive decline, but more work is needed to understand who might (and who might not) benefit Results show that hearing loss causes cognitive decline by increasing cognitive load Results show that language is the cognitive domain that hearing aids can improve the most

3.  Which of the following study design characteristics was used in the ACHIEVE study? Randomization of participants to the treatment or control group Masking of participants to whether they were assigned to the hearing treatment or control group Use of a no-contact control group Participants were randomly sampled from the community to participate in the study

4.  For a subset of ACHIEVE participants, the hearing intervention (vs. control) was associated with a 48% reduction in 3-year global cognitive. How do you explain this finding to a patient considering whether to get hearing aids? 48 of 100 patients who got hearing aids did not have cognitive decline Compared to someone who doesn’t get hearing aids, if you get hearing aids, your rate of cognitive decline will be slower by 48% If you are at risk for cognitive decline, hearing aids will prevent you from declining further Hearing aids slowed cognitive decline for some people, but not for all people in the study. If you are worried about cognitive decline, hearing aids may help you, but they may not.

5.  What research questions remain unanswered? Which patients will benefit from hearing aids with respect to their cognitive decline, and which patients will not? What are the long term (>3 years) effects of hearing aids on cognitive decline? Do hearing aids prevent dementia? All of the above