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Public Health.

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  • 1New York University, New York, NY, USA.

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Summary
This summary is machine-generated.

Hearing intervention slowed cognitive decline and neurodegeneration in older adults. This suggests a combined approach using biomarkers and cognition may improve clinical trial power for brain health interventions.

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Area of Science:

  • Neurology and Aging Research
  • Biomarker Discovery for Neurodegeneration
  • Clinical Trial Design Optimization

Background:

  • The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) trial found hearing intervention slowed cognitive decline by 48% in a subgroup.
  • Further investigation is needed to understand the impact of hearing intervention on neurodegeneration biomarkers.

Purpose of the Study:

  • To test if hearing intervention is associated with improved neurodegeneration blood biomarkers (GFAP and NfL) after 3 years.
  • To assess if combining cognitive and biomarker results enhances statistical power in clinical trial design.

Main Methods:

  • A randomized trial involving adults aged 70-84 with untreated hearing loss and no substantial cognitive impairment.
  • Plasma biomarkers (GFAP, NfL) were measured in a subsample (n=540) at 3 years; ARIC participants (n=164) also had baseline plasma.
  • Regression models analyzed the association of hearing intervention with 3-year biomarkers and cognitive changes, including a composite score.

Main Results:

  • No significant differences in 3-year biomarker levels were found in the combined or de novo groups.
  • Among Atherosclerosis Risk in Communities (ARIC) participants, hearing intervention was associated with lower 3-year GFAP and NfL levels.
  • In ARIC participants, intervention correlated with slower cognitive decline and a slower rate of GFAP increase.
  • A combined cognitive and biomarker score showed increased statistical power compared to cognition alone in the ARIC subgroup.

Conclusions:

  • Hearing intervention demonstrated positive effects on neurodegeneration biomarkers in ARIC participants, aligning with cognitive benefits.
  • These findings offer objective evidence of brain changes associated with hearing intervention.
  • A combined outcome measure may provide a more powerful approach for future brain health clinical trials.