Hearing intervention slows cognitive decline in older adults with hearing loss and at risk for cognitive decline

19 July 2023

  • Largest clinical trial to investigate whether a hearing loss treatment intervention can reduce the risk of cognitive decline1
  • Results presented at the Alzheimer's Association International Conference 2023 (AAIC®), Amsterdam and simultaneously published in The Lancet1

Sydney, Australia – 19 JULY 2023: New research presented this week found that in a subgroup of older adults with mild to moderate hearing loss who were at a higher risk of cognitive decline, hearing intervention for three years slowed cognitive decline by 48 percent.1

According to Dig Howitt, CEO and President of Cochlear, the result is a major advancement in understanding the broader impact of hearing loss and the need for adults, policy makers and health professionals to prioritise treatment of hearing loss.

“Healthy hearing is more than just being able to hear—it’s directly connected to our everyday health and wellbeing,” said Mr Howitt.

“Proactively treating hearing loss helps keep people socially connected, mentally well, and physically safe.

Treating hearing loss should be a public health priority for governments and healthcare providers. These data show that treating hearing loss not only helps people to hear, but also has the potential to reduce cognitive decline for adults at high risk.

Hearing loss can get worse over time, knowing when to address it with the right solution at the right time can help people reconnect to the life they love and keep their mind sharp.2

People living with hearing loss should get their hearing checked early.”

The study authors concluded that the results add to the growing evidence that support addressing modifiable risk factors for cognitive decline and dementia could be effective in reducing the future global burden of dementia.

About the ACHIEVE Study3

The ACHIEVE study is a randomised trial of older adults aged 70-84 with untreated hearing loss who were free from substantial cognitive impairment, conducted at four U.S. sites. 977 total participants were recruited from two study populations: 238 adults participating in the Atherosclerosis Risk in Communities (ARIC) study, and 739 healthy community volunteers newly recruited to the study.

The three-year intervention included use of hearing aids, a hearing "toolkit" to assist with self-management, and ongoing instruction and counseling with an audiologist. The comparison health education control group had talk sessions with a health educator about chronic disease prevention. The total study population was analysed, hearing intervention versus health education control; the ARIC and community subgroups were also analysed in this manner. The primary endpoint was three-year change in a comprehensive neurocognitive testing battery.

The results of the comparison of hearing intervention versus control in the total study population were negative, as was the community population comparison of hearing intervention versus control. The most notable result was the comparison of the ARIC subgroup hearing intervention versus control, in which a 48% slowing of cognitive decline was observed.

The researchers noted that the participants from the ARIC study had more risk factors for cognitive decline, lower baseline cognitive scores, and a faster rate of three-year cognitive decline during the study than the others.

The ACHIEVE study was led by co-Principal Investigators Frank Lin, MD, PhD and Josef Coresh, MD, PhD, Johns Hopkins Bloomberg School of Public Health, and is funded by grant #R01AG055426 from the National Institute on Aging, part of the U.S. National Institutes of Health. The study did not include people who were provided with hearing implants.

Initial results were presented at the Alzheimer's Association International Conference 2023 (AAIC®), in Amsterdam and simultaneously published in The Lancet.1

About Cochlear Limited (ASX: COH)

Cochlear is the global leader in implantable hearing solutions. The company has a global workforce of more than 4,000 people and invests more than AUD$180 million each year in research and development. Products include cochlear implants, bone conduction implants and acoustic implants, which healthcare professionals use to treat a range of moderate to profound types of hearing loss.

Since 1981, Cochlear has provided more than 700,000 implantable devices, helping people of all ages, in more than 180 countries, to hear.

For further information, please contact:
Aaron Dowling
Senior Communications Manager
Email: adowling@cochlear.com
Phone: +61 448 457 583


Please seek advice from your health professional about treatments for hearing loss. Outcomes may vary, and your health professional will advise you about the factors which could affect your outcome. Always follow the directions for use. Not all products are available in all countries. Please contact your local Cochlear representative for product information.

In Australia, Cochlear™ Nucleus® implant systems are intended for the treatment of moderately severe to profound hearing loss.

In Australia, Baha® bone conduction implant systems are intended for the treatment of moderate to profound hearing loss.

In Australia, the Cochlear™ Osia® System is indicated for patients with conductive, mixed hearing loss and single-sided sensorineural deafness (SSD) aged 10 years and above with up to 55 decibels sensorineural hearing loss. Patients should have sufficient bone quality and quantity to support successful implant placement. Surgery is required to use this product. Any surgical procedure carries risk.

For Cochlear™ Nucleus®, Osia® and Baha® systems: This product is not available for purchase by the general public. For information on funding and reimbursement please contact your health care professional.

Any testimonial featured on this website is intended for an Australian audience only.


  1. Lin FR et al. 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. The Lancet. [ePub ahead of print] DOI: https://doi.org/10.1016/S0140-6736(23)01406-X. Available at https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01406-X/fulltext
  2. Völter C et al. Can cochlear implantation improve neurocognition in the aging population? Clin Interv Aging. 2018; 13: 701–712.
  3. Clinicaltrials.gov. Aging and Cognitive Health Evaluation in Elders (ACHIEVE). NCT03243422. Available at https://classic.clinicaltrials.gov/ct2/show/NCT03243422