Sanchez Victoria A, Arnold Michelle L, Garcia Morales Emmanuel E, Reed Nicholas S, Faucette Sarah, Burgard Sheila, Calloway Haley N, Coresh Josef, Deal Jennifer A, Goman Adele M, Gravens-Mueller Lisa, Hayden Kathleen M, Huang Alison R, Mitchell Christine M, Mosley Thomas H, Pankow James S, Pike James R, Schrack Jennifer A, Sherry Laura, Weycker Jacqueline M, Lin Frank R, Chisolm Theresa H
Department of Otolaryngology-Head & Neck Surgery, University of South Florida, Tampa, Florida, USA.
Department of Communication Sciences & Disorders, University of South Florida, Tampa, Florida, USA.
J Am Geriatr Soc. 2024 Dec;72(12):3784-3799. doi: 10.1111/jgs.19185. Epub 2024 Sep 12.
The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) Study was designed to determine the effects of a best-practice hearing intervention on cognitive decline among community-dwelling older adults. Here, we conducted a secondary analysis of the ACHIEVE Study to investigate the effect of hearing intervention on self-reported communicative function.
The ACHIEVE Study is a parallel-group, unmasked, randomized controlled trial of adults aged 70-84 years with untreated mild-to-moderate hearing loss and without substantial cognitive impairment. Participants were randomly assigned (1:1) to a hearing intervention (audiological counseling and provision of hearing aids) or a control intervention of health education (individual sessions with a health educator covering topics on chronic disease prevention) and followed semiannually for 3 years. Self-reported communicative function was measured with the Hearing Handicap Inventory-Elderly Screening version (HHIE-S, range 0-40, higher scores indicate greater impairment). Effect of hearing intervention versus control on HHIE-S was analyzed through an intention-to-treat model controlling for known covariates.
HHIE-S improved after 6-months with hearing intervention compared to control, and continued to be better through 3-year follow-up. We estimated a difference of -8.9 (95% CI: -10.4, -7.5) points between intervention and control groups in change in HHIE-S score from baseline to 6 months, -9.3 (95% CI: -10.8, -7.9) to Year 1, -8.4 (95% CI: -9.8, -6.9) to Year 2, and - 9.5 (95% CI: -11.0, -8.0) to Year 3. Other prespecified sensitivity analyses that varied analytical parameters did not change the observed results.
Hearing intervention improved self-reported communicative function compared to a control intervention within 6 months and with effects sustained through 3 years. These findings suggest that clinical recommendations for older adults with hearing loss should encourage hearing intervention that could benefit communicative function and potentially have positive downstream effects on other aspects of health.
老年人衰老与认知健康评估（ACHIEVE）研究旨在确定最佳实践听力干预对社区居住的老年人认知衰退的影响。在此，我们对ACHIEVE研究进行了二次分析，以调查听力干预对自我报告的沟通功能的影响。
ACHIEVE研究是一项平行组、非盲、随机对照试验，对象为年龄在70 - 84岁、患有未经治疗的轻度至中度听力损失且无严重认知障碍的成年人。参与者被随机分配（1:1）接受听力干预（听力学咨询和提供助听器）或健康教育对照干预（与健康教育者进行个人课程，涵盖慢性病预防主题），并每半年随访3年。自我报告的沟通功能用听力障碍库存 - 老年人筛查版（HHIE - S，范围0 - 40，分数越高表明损伤越大）进行测量。通过控制已知协变量的意向性分析模型分析听力干预与对照对HHIE - S的影响。
与对照组相比，听力干预6个月后HHIE - S有所改善，并在3年随访期间持续改善。我们估计干预组与对照组在从基线到6个月HHIE - S评分变化上的差异为 - 8.9（95%置信区间： - 10.4， - 7.5）分，到第1年为 - 9.3（95%置信区间： - 10.8， - 7.9）分，到第2年为 - 8.4（95%置信区间： - 9.8， - 6.9）分，到第3年为 - 9.5（95%置信区间： - 11.0， - 8.0）分。其他改变分析参数的预先指定的敏感性分析未改变观察结果。
与对照干预相比，听力干预在6个月内改善了自我报告的沟通功能，且效果持续3年。这些发现表明，针对听力损失老年人临床建议应鼓励听力干预，这可能有益于沟通功能，并可能对健康的其他方面产生积极的下游影响。
