Effects of hearing intervention on blood-based biomarkers of neuroinflammation and neurodegeneration: a secondary analysis of the ACHIEVE randomised controlled trial
Year: 2026
Type: article
Abstract: Background: Research suggests that hearing loss in older adults is associated with elevated neuroinflammation and neurodegeneration, both of which are risk factors for dementia. In a secondary analysis of the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) randomised controlled trial (ClinicalTrials.gov identifier: NCT03243422), we examined if hearing intervention slowed 3-year change in blood-based biomarkers of neuroinflammation (glial fibrillary acidic protein [GFAP]) and neurodegeneration (neurofilament light chain [NfL]). Methods: ACHIEVE, a clinical trial in the United States conducted between January 4, 2018 and November 30, 2022, tested the effects of hearing intervention (audiological counselling, provision of hearing aids) versus health education control (counselling on chronic disease prevention) on 3-year cognitive decline among older adults without substantial cognitive impairment and with untreated hearing loss. Plasma was collected at baseline and three years later among ACHIEVE participants recruited from the Atherosclerosis Risk in Communities cohort. Covariate-adjusted linear mixed effects models estimated intention-to-treat effects on 3-year change in inverse-normal transformed values of GFAP and NfL. Findings: Participants in the analytic sample (n = 164) were mean (SD) age 78.1 (2.9) years, 64.0% female, and 73.2% White. Over three years, hearing intervention was associated with a slower rise in GFAP (intervention: -0.026; 95% CI: -0.144, 0.093, control: 0.149; 95% CI: 0.039, 0.260; difference: -0.175; 95% CI: -0.322, -0.028; p-difference: 0.019) and NfL (intervention: 0.171; 95% CI: 0.022, 0.319, control: 0.330; 95 %CI: 0.185, 0.475, difference: -0.159; 95 %CI: -0.348, 0.029; p-difference: 0.098). Interpretation: Randomisation to hearing intervention was associated with a slower three-year rise in a blood-based biomarker of neuroinflammation. Comparable estimates were observed for neurodegeneration, although the effect was not statistically significant. Findings suggest that hearing intervention may reduce the rate of change in non-specific blood-based biomarkers associated with brain health and dementia progression. Funding: US National Institutes of Health.
Source: EClinicalMedicine
Authors: James Russell Pike, Alison R. Huang, Nicholas Reed, Michelle L. Arnold, Theresa H. Chisolm, David Couper, Jennifer A. Deal, Sarah Faucette, Adele M. Goman, Rebecca F. Gottesman, Timothy M. Hughes, David Knopman, Christine Mitchell, Thomas H. Mosley, Priya Palta, James S. Pankow, Victoria A. Sanchez, Elizabeth Selvin, Kevin J. Sullivan, Bharat Thyagarajan, Lynne E. Wagenknecht, Frank R. Lin, Josef Coresh, Josef Coresh, Jennifer A. Deal, Frank R. Lin, Marilyn Albert, Joshua Betz, Alden Gross, Christine M. Mitchell, Clarice Myers, Jennifer A. Schrack, Richey Sharrett, Josef Coresh, Josef Coresh, James R. Pike, Nicholas S. Reed, Alison R. Huang, Melissa Minotti, Spencer Bolton, Laura Sherry, James S. Pankow, Sarah Aguilar, Elizabeth Anderson, Sydney Boelter, Elizabeth Penland Miller, Debbie Ng, Kristi Oeding, Sandra Potter, Katherine Teece, Soni Uccellini, Matthew Waggenspack, Luanne Welch, Jacqueline Weycker, Kerry Witherell, Kevin Sullivan, Thomas Mosley, Latilraka Anderson, Jillian Burt, April Carr, Arkenya Carter, Sarah Faucette, Rachel Foster, Ceola Greenwood, Temeka Griffin, Candace Jones, Dawn McLendon, Thomas Mosley, Stacee Naylor, Jenny Newman, Deidre O’Connor, Tiffany Owens, Jeraline Sims, Allison Thweatt, Tamikia Washington, Lynne E. Wagenknecht, Kathleen M. Hayden, Bria Backman, Debbie Barr, Joshua Evans, Jaime Hampton, Hailley Humphrey-Rutledge, Kaila H. Liou, Ashely Mitchell, Susan Smith, Nadine Shelton, Theresa Chisolm, Victoria Sanchez, Michelle Arnold, Ann C. Eddins, Emily Moore, Haley Neil, Preyanca Oree, Laura Westermann, Nancy W. Glynn, Yurun Cai, Theresa Gmelin, David Couper, Sheila Burgard, Lisa Gravens-Mueller, David Li, Adele M. Goman, Clifford R. Jack, David Knopman, Denise Reyes, A.J. Spychalla, Kaely Thostenson, Doug Galasko, Julie Buring, Judy Dubno, Tom Greene, Lawrence Lustig, Coryse St. Hillaire-Clarke, Matt Sutterer
Institutions: New York University, Johns Hopkins University, University of South Florida, University of North Carolina at Chapel Hill, Johns Hopkins Medicine, University of Mississippi Medical Center, University of Leeds, National Institutes of Health, National Institute of Neurological Disorders and Stroke, Wake Forest University Health Sciences, Wake Forest University, Mayo Clinic, University of Minnesota
Language: English
Subfield: Cognitive Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $5,780
Awards: Aging, Cognition, and Hearing Evaluation in Elders (ACHIEVE) Randomized Trial, ARIC Neurocognitive Study (ARIC-NCS) Renewal UNC 4 of 5, ARIC Neurocognitive Study (ARIC-NCS) Renewal 4 of 5, Hearing loss, brain aging, and speech-in-noise performance in the ACHIEVE study, ARIC Neurocognitive Study (ARIC-NCS) Renewal 2 of 5, ARIC Neurocognitive Study (ARIC-NCS), Planning a trial of hearing rehabilitative treatment to reduce cognitive decline, The ARIC and Neurocognitive Longitudinal Study, ARIC Neurocognitive Study (ARIC-NCS) Renewal 2023-2028, Long-term effects of hearing intervention on brain health in the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) randomized study
OpenAlex ID: W7207566374