Show 1364: Staying Sharp Through Better Hearing

This week’s interviews focus on the benefits of better hearing. Dr. Frank Lin describes the results of the ACHIEVE, in which some participants got a very significant delay in the onset of cognitive decline if they were provided with needed hearing aids. We also talk with a reporter about recently introduced over-the-counter devices.

The Link Between Hearing Impairment and Cognitive Decline:

Scientists have known for at least a decade that people with auditory impairment are more likely to experience cognitive decline as well. One might logically conclude, therefore, that improved hearing would help ward off cognitive problems. But that assumption was not tested scientifically until just recently.

What the ACHIEVE Trial Tells Us About Better Hearing:

To find out how hearing affects cognition, the scientists leading the ACHIEVE (Aging and Cognitive Health Evaluation in Elders) trial recruited nearly 1,000 people between 70 and 84 years of age. Approximately two hundred of these individuals were already participating in a long-term study of cardiovascular health, called Atherosclerosis Risk in Communities, or ARIC. They were representative of the American population.

In addition, more than 750 people volunteered because they were interested in the study and its outcomes. These participants were, on the whole, healthier and more engaged in their health care. Investigators randomly assigned all the volunteers to either get interventions to improve their hearing or a regular general health education session. They also administered cognitive tests repeatedly to every participant over the three years of the study.

The results might seem discouraging; in the entire group, audiological interventions did not change cognitive scores. However, when the scientists analyzed the two groups of volunteers separately, a striking picture emerged. The older, less healthy participants from ARIC had almost 50 percent less cognitive decline in three years if they got hearing aids. As Dr. Lin describes it, the other healthy volunteers were already doing so well that they had very little room for improvement (Lancet, Sep. 2, 2023).

Why Not Opt for Better Hearing?

The ACHIEVE study focused on older people. Many of us associate hearing impairment with older people, but that is an unfair stereotype. Although this problem becomes more common as we age, many younger people also have compromised hearing. As with other health interventions, earlier assessment and correction is likely to be more effective. Hearing aids do not carry medical risks, whereas poor hearing can jeopardize social and mental health as well as cognitive well-being (Journal of Gerontology, Series A: Biological Sciences and Medical Sciences, Aug. 14, 2023).

How Is Your Hearing?

Each of us should take advantage of the opportunity to evaluate our hearing and we should know our hearing number. You can learn more at hearingnumber.org.  This will allow standards to be set for hearing technology across many platforms.

Over-the-Counter Hearing Aids:

In addition to our conversation with Dr. Lin, we also speak with Catherine Roberts, a health journalist for Consumer Reports. She describes the differences between the new OTC hearing aids, which are intended to compensate for mild to moderate hearing loss, and Personal Sound Amplification Products. These older devices are meant for people without auditory impairment in special situations such as hunting or birdwatching.

How Do Prescription and OTC Hearing Aids Differ?

One big difference is price. Although OTC aids aren’t exactly cheap, at $700 or $800 a pair they are much more affordable than the $1600 or so you would pay for the least expensive prescription aids. What you give up when you opt for OTC devices is the assistance of an audiologist in helping you adjust the technology. Instead, you do that yourself. For many tech-savvy individuals with mild hearing loss, that is no great sacrifice. For others, it may be too big a burden.

This Week's Guests:

Frank Lin, MD, PhD, is Co-Principal Investigator of the ACHIEVE study. In addition, he is Professor of Otolaryngology at Johns Hopkins University School of Medicine and Director of the Cochlear Center for Hearing and Public Health at the Bloomberg School of Public Health.
https://www.achievestudy.org/

Catherine Roberts is a health journalist for Consumer Reports. As a health journalist, Catherine Roberts’ goal is to empower consumers to make informed decisions about health products, practices, and treatments. https://www.consumerreports.org/cro/about-us/our-people/our-experts/catherine-roberts/index.htm
She has written “A Complete Guide to Over-the-Counter Hearing Aids.”  You will find it informative.