Effects of hearing intervention on falls in older adults: Findings from a secondary analysis of the ACHIEVE randomized controlled trial

Research Output

Background
Hearing loss is highly prevalent among older adults and has been associated with an increased likelihood of falling. We aimed to examine the effect of a hearing intervention on falls over three years among older adults in a secondary analysis of the ACHIEVE study.
Methods
ACHIEVE is an unmasked randomized trial (ClinicalTrials.gov: NCT03243422) of adults aged 70-84 years with untreated hearing loss and without substantial cognitive impairment. Participants were recruited at four US community sites from two study populations: an ongoing observational study of cardiovascular health (ARIC) or de novo. Participants were randomized 1:1 to a hearing intervention (audiologic counselling and provision of hearing aids) or health education control (didactic education and enrichment activities covering chronic disease prevention topics). Self-reported falls were assessed at baseline and annually and analysis was by intention to treat.
Findings
Between November 9 2017 and October 25 2019, 3004 participants were screened for eligibility and a total of 977 (238 from ARIC and 739 de novo) participants were randomized, with 490 in the intervention group and 487 in the control group. Participants had a mean age of 76.8 years (SD=4.0), 523 were female (53.5%), 112 were Black (11.5%), and 858 were White (87.8%). In adjusted analyses, the intervention group had a 27% reduction in the average number of falls compared to control (mean falls over 3-years [95% confidence interval]: intervention 1.45 [1.28, 1.61], control: 1.98 [1.82, 2.15], difference: -0.54, [-0.77, -0.31]). The 3-year protective effect of hearing intervention was consistent across both the ARIC and de novo study populations.
Interpretation
Hearing intervention versus control was associated with a reduction in the average number of falls over 3-years in older adults. Continued follow up of ACHIEVE participants will enable examination of the longer-term effects of a hearing intervention on falls.
Funding
US National institutes of Health

Date:

27 May 2025
Publication Status:

Published
DOI:

10.1016/S2468-2667(25)00088-X
Funders:

National Institutes of Health

http://researchrepository.napier.ac.uk/output/4185001 Goman, A. M., Tan, N., Pike, J., Bessen, S. Y., Chen, Z. (., Huang, A. R., Arnold, M. L., Burgard, S., Chisolm, T. H., Couper, D., Deal, J. A., Glynn, N. W., Gmelin, T., Gravens-Mueller, L., Hayden, K. M., Martinez-Amezcua, P., Mitchell, C. M., Pankow, J. S., Reed, N. S., Sanchez, V. A., …Lin, F. R. (2025). Effects of hearing intervention on falls in older adults: Findings from a secondary analysis of the ACHIEVE randomized controlled trial. The Lancet Public Health, 10(6), e492-e502. https://doi.org/10.1016/S2468-2667%2825%2900088-X

Citation

Goman, A. M., Tan, N., Pike, J., Bessen, S. Y., Chen, Z. (., Huang, A. R., Arnold, M. L., Burgard, S., Chisolm, T. H., Couper, D., Deal, J. A., Glynn, N. W., Gmelin, T., Gravens-Mueller, L., Hayden, K. M., Martinez-Amezcua, P., Mitchell, C. M., Pankow, J. S., Reed, N. S., Sanchez, V. A., …Lin, F. R. (2025). Effects of hearing intervention on falls in older adults: Findings from a secondary analysis of the ACHIEVE randomized controlled trial. The Lancet Public Health, 10(6), e492-e502. https://doi.org/10.1016/S2468-2667%2825%2900088-X