Hearing Aids Can Slow Rate of Cognitive Decline by Nearly Half

Odalie Haines is very fond of doo-wop music from the 1960s and treasures fun talks with her family and neighbors, but doing the things she loves proved more difficult with untreated hearing loss.

For Reverend L. Samuel Martz, his life mission is to listen to others and give good counsel, and being able to hear others clearly is imperative.

Both participated in ACHIEVE, a landmark study that involved 1,000 older adults, aged 70-84, recruited from four field sites across the United States, including the Johns Hopkins University George W. Comstock Center for Public Health Research and Prevention. ACHIEVE stands for Aging and Cognitive Health Evaluation in Elders.

All participants had mild to moderate hearing loss, and the three-year study, published in The Lancet, found that for those at most risk who were given hearing interventions – like hearing aids – cognitive decline slowed by a significant 48%.

“After a decade of epidemiological research, we knew hearing loss is arguably the single largest risk factor for dementia, but what we never knew, honestly, was if treating hearing loss using our existing interventions could in fact lead to reduced risk of these adverse outcomes,” says Frank Lin, Med ’03 (MD), BSPH ’08 (PhD), professor in the Department of Otolaryngology-Head & Neck Surgery at the Johns Hopkins Hospital and director of the Cochlear Center for Hearing and Public Health at the Bloomberg School of Public Health.

“This is what the ACHIEVE study was designed to answer, and the results were substantial,” Lin says, explaining that increased risk factors for hearing loss include diabetes and high blood pressure.

In addition to proving the efficacy of hearing aids in slowing the loss of thinking and memory abilities, the study also produces a fuller understanding of the three mechanisms by which hearing loss contributes to cognitive decline: the brain’s working harder to process sound and depleting reserves which might otherwise help protect the brain; auditory deprivation causing structural atrophy to some neural networks; and social withdrawal as it becomes harder to engage with others.

“Hearing loss is a natural part of aging, and almost two-thirds of people over 60 have a significant hearing loss,” according to Lin. “But it’s amazing how hearing affects so many aspects of health. Imagine speaking with your doctor. If you can’t really understand or hear your doctor well, you may not get much out of the visit.”

Other literature indicates how a loss of hearing can contribute to falls and hospital admissions, he says, pointing to larger societal implications.

“These adverse events can be extremely costly for a healthcare system as a whole, especially one increasingly focused on a huge population of older adults. This has carry-over effects that stretch far beyond even cognitive health, to much more concrete economic outcomes as well,” Lin adds.

In addition to his work as a researcher, clinician, and surgeon, Lin was also instrumental in advocating for the passage of the Over-the Counter Hearing Act of 2017, which reduced the cost of hearing aids by making them available without a prescription.

Early seed money and continual support from the Eleanor Schwartz Charitable Foundation helped fuel Lin’s advocacy work and jumpstart the ACHIEVE trial, as well as attract other donors like Cochlear Limited, whose additional support further accelerated the pace of this research.

“Philanthropy is the glue that holds everything together and allows us to reap much larger rewards,” Lin says. “And my passion comes from my desire to change the world, to have an impact at a global scale.”

“But ultimately, the reason why I do it is because of what I’ve observed among my patients about how hearing impacts their lives and how it’s impacted their ability to engage with the world around them,” adds Lin, who is currently also collaborating with both industry and nonprofit organizations on the Hearing Number initiative to help people become more aware of how to gauge their hearing ability.

Both Martz and Haines share that participating in the ACHIEVE trail has had a major impact in their lives.

“Maybe I’ve been hard of hearing longer than I thought,” says Martz, joking that his wife suggested he join the ACHIEVE trial. “But I have a lot of goals in life. I want to keep active, and ACHIEVE has helped me fulfill my life’s desire which is to keep ministering.”

“It makes me feel good about myself because I can interact with people,” says Haines about the hearing aid she received through the ACHIEVE trial. “I can do more things, and I don’t have to feel like I’m left out of the conversation. I would advise anyone to get a hearing aid.”