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Life Guide U.S. essentials
English

If your hearing is getting worse, get hearing aids, and do it so you can hear, not to prevent dementia

  • Moderate value
  • Evidence A
  • Buys life
  • Disputed
  • Costs a lot
  • Takes some hours
  • Some willpower

In plain words

The claim that “wearing hearing aids prevents dementia” has not held up so far. A three-year trial of nearly 1000 people showed no difference overall. A difference was seen only in the subgroup whose risk of cognitive decline was higher to begin with. So the reason to get hearing aids is to hear right now, to talk with people, and to hear cars when crossing the road, not to protect your brain decades later.

Cost

Hearing aids cost a few thousand to a few tens of thousands of yuan, and most must be paid for out of pocket. They need to be fitted, and adjusted several times.

What you get

The ACHIEVE trial was done in 4 communities in the U.S. and included 977 people aged 70 to 84 who had untreated hearing loss and no marked cognitive impairment. They were randomly split into two groups, one receiving a hearing intervention (hearing counseling and hearing aids) and the other a health education control, with follow-up every 6 months. The main outcome was the change in overall cognitive score over 3 years. In the main analysis combining the two source populations, the groups did not differ significantly: −0.200 (95% CI −0.256 to −0.144) in the hearing intervention group and −0.202 (95% CI −0.258 to −0.145) in the control group, a difference of 0.002 (95% CI −0.077 to 0.081), P=0.96. A pre-specified sensitivity analysis showed that the effect of the intervention differed between the two source populations (interaction P=0.010). The participants from the long-running cardiovascular health observational study were older, had more risk factors for cognitive decline, and had lower baseline cognitive scores. The researchers concluded that a hearing intervention may reduce 3-year cognitive change in people at higher risk of cognitive decline, but not in people at lower risk. The trial reported no serious adverse events attributed to the study.

Notes

Disputed: the claim common online that “hearing aids cut cognitive decline by nearly half” comes from one subgroup in this trial and is not its main result; the main result is that the groups did not differ. Treat “getting hearing aids” and “preventing dementia” separately: do the former, and don't use the latter as the reason. Candidates with hearing disabilities in the college entrance exam can be exempted from the foreign-language listening section; see §33.13 (reasonable accommodations). People with hearing impairment should wear hearing devices when driving; see §33.15 (C5).

Evidence grade
A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
Sources
  1. Lin FR, Pike JR, Albert MS, et al.; ACHIEVE Collaborative Research Group (2023). Hearing intervention versus health education control to reduce cognitive decline in older adults with hearing loss in the USA (ACHIEVE): a multicentre, randomised controlled trial. Lancet, 402(10404):786-797. https://doi.org/10.1016/S0140-6736(23)01406-X

Translated from the Chinese original. Original book, section 33, tip 17. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer