Hearing aids of little help in preventing dementia in older adults with hearing loss, MCI

A hearing aid intervention does little to reduce the incidence of dementia-level impairment in older adults with coexisting hearing loss and mild cognitive impairment (MCI), as shown in the CHOICE trial.

The 24-month CHOICE trial was conducted at multiple tertiary otology outpatient clinics and cohort community health stations in Shanghai, China. A total of 703 patients (mean age 74.53 years, 64.44 percent male) with MCI (Clinical Dementia Rating [CDR] global score of 0.5) and moderate-to-severe hearing loss were randomly assigned to undergo a hearing aid intervention (n=353) or hearing care education (n=350).

Patients in the intervention group received binaural behind-the-ear hearing aids, with the goal of achieving at least a 15-dB improvement in the pure tone average threshold in addition to self-reported benefit. These patients were advised to consistently wear their hearing aids during waking hours and remove them only for sleeping, showering, or other situations involving water exposure. On the other hand, patients in the control group underwent a structured educational programme conducted by trained researchers during scheduled follow-up visits. 

The primary outcome was the conversion rate from MCI to dementia-level impairment (CDR global score ≥1) over 24 months. Secondary outcomes included cognitive improvement (CDR=0) and CDR global and domain scores.

A total of 610 patients (86.77 percent) completed the trial. The primary outcome occurred in 3.09 percent of patients in the intervention group vs 4.74 percent in the control group (relative risk [RR], 0.59, 95 percent confidence interval [CI], 0.25–1.38; p=0.23).

Meanwhile, the proportion of patients achieving cognitive improvement was higher in the intervention group than in the control group, at 15.34 percent vs 2.36 percent (RR, 5.94, 95 percent CI, 2.46–14.37).

There were no study-related adverse events reported.