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

Adele M Goman; Nasya Tan; James Russell Pike; Sarah Y Bessen; Ziheng Sally Chen; Alison R Huang; Michelle L Arnold; Sheila Burgard; Theresa H Chisolm; David Couper; Jennifer A Deal; Nancy W Glynn; Theresa Gmelin; Lisa Gravens-Mueller; Kathleen M Hayden; Pablo Martinez-Amezcua; Christine M Mitchell; James S Pankow; Nicholas S Reed; Victoria A Sanchez; Jennifer A Schrack; Kevin J Sullivan; Josef Coresh; Frank R Lin; ACHIEVE Collaborative Research Group

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

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

Lancet Public Health. 2025 Jun;10(6):e492-e502. doi: 10.1016/S2468-2667(25)00088-X.

Authors

Adele M Goman¹, Nasya Tan², James Russell Pike³, Sarah Y Bessen⁴, Ziheng Sally Chen⁵, Alison R Huang⁶, Michelle L Arnold⁷, Sheila Burgard⁸, Theresa H Chisolm⁷, David Couper⁸, Jennifer A Deal⁹, Nancy W Glynn¹⁰, Theresa Gmelin¹⁰, Lisa Gravens-Mueller⁸, Kathleen M Hayden¹¹, Pablo Martinez-Amezcua⁹, Christine M Mitchell¹², James S Pankow¹³, Nicholas S Reed¹⁴, Victoria A Sanchez¹⁵, Jennifer A Schrack¹⁶, Kevin J Sullivan¹⁷, Josef Coresh³, Frank R Lin⁹; ACHIEVE Collaborative Research Group

Affiliations

¹ School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK; Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: a.goman@napier.ac.uk.
² Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
³ Department of Population Health and Medicine, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA.
⁴ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, USA.
⁵ School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK.
⁶ Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, USA.
⁷ Department of Communication Sciences & Disorders, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA.
⁸ Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
⁹ Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, USA.
¹⁰ Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
¹¹ Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
¹² Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
¹³ Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA.
¹⁴ Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Population Health and Medicine, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA; Department of Otolaryngology-Head and Neck Surgery, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, USA.
¹⁵ Department of Otolaryngology - Head & Neck Surgery, University of South Florida, Tampa, FL, USA.
¹⁶ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
¹⁷ The MIND Center, University of Mississippi Medical Center, Jackson, MS, USA.

Abstract

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 3 years among older adults in a secondary analysis of the ACHIEVE study.

Methods: The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study was a 3-year, unmasked, randomised controlled trial of adults aged 70-84 years at enrolment with untreated hearing loss and without substantial cognitive impairment. Participants were recruited at four US community-based field sites from two study populations: (1) an ongoing observational study of cardiovascular health (Atherosclerosis Risk in Communities [ARIC] study), and (2) de novo from the community. Participants were randomly assigned (1:1) to a hearing intervention (audiological counselling and provision of hearing aids) or a health education control (didactic education and enrichment activities covering chronic disease prevention topics). A prespecified exploratory outcome was falls. Self-reported falls in the past 12 months were assessed at baseline and annually for 3 years, and analysed by intention to treat with covariate adjustment. The study was registered with ClinicalTrials.gov, NCT03243422, and is completed.

Findings: Between Nov 9, 2017, and Oct 25, 2019, 3004 individuals were screened for eligibility and 977 (238 [24%] from the ARIC study and 739 [76%] de novo) were randomly assigned, with 490 (50%) in the hearing intervention group and 487 (50%) in the health education control group. Overall mean age was 76·8 years (SD 4·0), 523 (54%) participants were female and 454 (46%) were male, and 112 (11%) were Black, 858 (88%) were White, and seven (1%) were other race. In adjusted analyses, the intervention group had a 27% reduction in the mean number of falls over 3 years compared with the control group (intervention group: 1·45 [95% CI 1·28 to 1·61]; control group: 1·98 [1·82 to 2·15]; mean difference: -0·54 [95% CI -0·77 to -0·31]). This 3-year effect of hearing intervention was consistent across both the ARIC and de novo study populations.

Interpretation: Hearing intervention versus a health education control was associated with a reduction in the mean number of falls over 3 years in older adults. Ongoing follow-up of ACHIEVE participants in a separate follow-up study (NCT05532657) will enable examination of the longer term effects of hearing intervention on falls.

Funding: US National Institutes of Health.

Publication types

Randomized Controlled Trial

MeSH terms

Accidental Falls* / prevention & control
Accidental Falls* / statistics & numerical data
Aged
Aged, 80 and over
Female
Hearing Aids*
Hearing Loss* / therapy
Humans
Male
United States

Associated data

ClinicalTrials.gov/NCT03243422

Abstract

Publication types

MeSH terms

Associated data

Grants and funding