Using hearing aids can slow cognitive decline in older adults with hearing loss who are also at risk for memory and thinking problems, according to recent research.

A large clinical trial found that for older adults at risk of cognitive issues, using hearing aids for three years cut their rates of cognitive decline in half.

While previous research has shown that hearing loss is a risk for developing dementia, the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study was the first randomized, controlled clinical trial to assess the effect of intervening with hearing aids. Results from the study were reported at the Alzheimer's Association International Conference and simultaneously published in The Lancet.

David Knopman, M.D., a Mayo Clinic neurologist and study co-investigator, says the study shows positive benefits in delaying cognitive decline for people roughly age 75 and older with hearing loss.

"Older individuals who are at risk for cognitive decline but who are still (cognitively) normal, who can still operate the hearing aids, who won't lose the hearing aids, are likely to achieve some benefit," Dr. Knopman says.

Watch: Dr. David Knopman talks about the clinical trial

Study: Hearing aids slowed cognitive decline by 48%

The ACHIEVE study, conducted at four U.S. sites, is a randomized trial of older adults aged 70 to 84 with untreated hearing loss who were free from substantial cognitive impairment. Nearly 1,000 participants were recruited from two study populations: 238 adults participating in the Atherosclerosis Risk in Communities (ARIC) study, and 739 healthy community volunteers. At the start of the trial, all study participants had mild to moderate hearing loss typical of older adults but no substantial cognitive impairment.

The three-year intervention included the use of hearing aids, a hearing “toolkit” to assist with self-management and ongoing instruction and counseling with an audiologist.

In the total study group, hearing aids did not reduce cognitive decline. However, the hearing intervention slowed cognitive decline in older adults with mild to moderate hearing loss by 48% in people participating in the ARIC study, an ongoing observational study of heart health.

Quality of life issue

Dr. Knopman notes that hearing aids may improve the quality of life for people with hearing loss at any age.

"Hearing loss is a disability that interferes with their quality of life, and they ought to think about getting a hearing aid if it would benefit them in their daily lives, regardless of whether it has this additional long-term benefit of delaying cognitive decline," he says.

Hearing and memory are separate but strongly interrelated brain processes that help control people's daily functioning and communication, Dr. Knopman says.

"If I don't quite hear what you say, but I have a good memory, I might be able to play it back in my head, so to speak, and figure it out because I have intact short-term memory," he says. "On the other hand, if I have impaired short-term memory and my hearing isn't as good, that function is going to be lost."

Almost two-thirds of adults over age 60 have hearing loss, according to researchers in the ACHIEVE study.

Related posts:

Mayo Clinic Minute: How hearing affects your brain health

Mayo Clinic Q and A: Tips for reducing risk of hearing loss  

Mayo Clinic Q and A: Are over the counter hearing devices a fit for you?

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Last week, the Food and Drug Administration approved aducanumab to treat Alzheimer’s disease, which is a progressive brain disorder that is the most common cause of dementia. 

Aducanumab targets amyloid plaques in the brain that are believed to be an essential component of Alzheimer’s disease. But what does the approval of a new Alzheimer's drug mean for patients?

On the Mayo Clinic Q&A podcast, Dr. Ronald Petersen, a Mayo Clinic neurologist and director of Mayo Clinic’s Alzheimer’s Disease Research Center, and Dr. David Knopman, a Mayo Clinic neurologist, discuss the challenges ahead to identify the appropriate patients for treatment with aducanumab.

Watch: Dr. Ronald Petersen and Dr. David Knopman discuss new Alzheimer's drug.

Read the full transcript.

Read more: FDA approves aducanumab to treat Alzheimer's disease

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Disclosures

Dr. Petersen has consulted with Biogen on aducanumab, but he was not involved in the design or execution of the clinical trials.

Dr. Knopman is a former member of the FDA's Peripheral and Central Nervous System Advisory Committee, but he was recused for the aducanumab advisory hearing because he was a site principal investigator for one of Biogen's aducanumab trials.

Mayo Clinic campuses in Rochester, Minnesota, and Jacksonville, Florida, participated in aducanumab clinical trials.

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The Food and Drug Administration (FDA) approved aducanumab to treat Alzheimer's disease on Monday, June 7. About 6 million people in the U.S. and 30 million worldwide are living with Alzheimer's disease, a progressive brain disorder that is the most common cause of dementia.

"I think this is good news for our patients with Alzheimer's disease who now have a therapy that attacks one of the underlying causes of the disease," says Ronald Petersen, M.D., Ph.D., neurologist and director of Mayo Clinic's Alzheimer's Disease Research Center. Dr. Petersen is the Cora Kanow Professor of Alzheimer's Disease Research and the Chester and Debbie Cadieux Director of Mayo Clinic Alzheimer's Disease Research Center.

Aducanumab targets amyloid plaques in the brain that are believed to be an essential component of Alzheimer's disease.

"There is certainly great demand for a therapy for Alzheimer's that significantly slows down the disease, and I hope that aducanumab will deliver on that goal," says David Knopman, M.D., a Mayo Clinic neurologist.

With no drugs on the market to treat the underlying cause of disease, the FDA's decision came after months of study and debate in the Alzheimer's disease research field.

Biogen, the drug's manufacturer, stopped clinical trials. Later Biogen reevaluated its data, determining one trial was positive and one was negative. Biogen sought FDA approval, but an FDA advisory committee voted against it in November 2020.

As scientists and patient advocate communities have examined the issue, one question was whether the drug slowed Alzheimer's disease progression enough to offer patients benefits, compared with the risk of side effects.

"Due to the underlying nature of the Alzheimer's process, treating amyloid would not be expected to produce a large clinical effect, but the FDA was convinced that sufficient evidence was demonstrated," Dr. Petersen says.

In clinical trials, aducanumab — an IV drug — was tested with people who were in an early stage of Alzheimer's disease and showing symptoms, such as memory loss, and who tested positive for amyloid plaques in the brain.

"The small benefits of aducanumab pose a real challenge for justifying the large investment in time and effort on the part of the patient and family, as well as the health care system," Dr. Knopman says.

Now that the drug is approved, specific guidance has not yet been determined about patient eligibility, but patients and their families are encouraged to talk to their health care providers.

"A great deal of work lies ahead to choose which patients might be eligible for the treatment and to monitor safety," Dr. Petersen says.

Dr. Knopman agrees. "Identifying the right patients for aducanumab will be a challenge and so will the safe management of the treatment," he says.

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About Mayo Clinic
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Media contact:

• Susan Barber Lindquist, Mayo Clinic Public Affairs, newsbureau@mayo.edu

_____________________________________________________

Disclosures

Dr. Petersen has consulted with Biogen on aducanumab, but he was not involved in the design or execution of the clinical trials.

Dr. Knopman is a former member of the FDA's Peripheral and Central Nervous System Advisory Committee, but he was recused for the aducanumab advisory hearing because he was a site principal investigator for one of Biogen's aducanumab trials.

Mayo Clinic campuses in Rochester, Minnesota, and Jacksonville, Florida, participated in aducanumab clinical trials.

The post FDA approves aducanumab to treat Alzheimer’s disease appeared first on Mayo Clinic News Network.

ANSWER: Doing activities that stimulate your brain may reduce your risk of developing dementia. But it’s more complex than taking up puzzles or computer games at age 65. Research suggests that the value of cognitively stimulating activities builds up over a lifetime. That means acquiring a good education; working in a job that is mentally stimulating; and engaging in pastimes, hobbies and social activities that are mentally engaging are all part of reducing your risk for developing dementia.

For example, studies have shown that the more years of education a person has, the lower the dementia risk. This appears to be because people who spend more time engaged in learning across their lifetimes tend to develop more robust networks of nerve cells and connections between those nerve cells within their brains. Those networks are better equipped to handle the cell damage that can happen as a result of brain disorders that may lead to dementia.

Before continuing, it would be wise to define “dementia.” Dementia describes symptoms that affect a person’s memory, thinking and social abilities to the point that it’s difficult to perform normal daily activities. Dementia is caused by brain disease. Alzheimer’s disease is the most common and one of the most well-known. Diseases that affect the blood vessels — the same diseases that cause heart attacks and stroke — are the second most common cause of dementia.

So, in addition to participating in activities that are mentally engaging, avoiding conditions that increase heart attacks and strokes also reduces your risk of dementia. Maintaining healthy levels of cholesterol and blood pressure, avoiding diabetes, not smoking, staying at a healthy weight and exercising regularly all have been shown to improve cognitive health later in life. Again, however, it’s best if you make them components of a healthy lifestyle in your younger years and sustain them as you get older. That’s because all of them affect the health of the blood vessels in your brain.

If your brain blood vessels stay in good condition throughout your young adulthood and midlife, they are more likely to be able to remain healthy as you age. If the health of those blood vessels deteriorates when you are younger, it’s difficult to mend the damage later. And damage to the brain’s blood vessels can be a factor in dementia.

This is not to say that incorporating healthy choices into your lifestyle if you are older won’t make any difference. They can positively affect your cognitive and physical health. But to gain the most benefit for your brain, it’s best to have them in place as soon as possible.

Social interaction is an area where anyone can make a change at any time, and it will likely have positive cognitive benefits. Regularly interacting with others — family, friends, neighbors, co-workers, community members — can lift your mood, improve your outlook and engage your brain. All of these positively affect your cognitive abilities, and being socially engaged has been shown to ease symptoms of dementia. — Dr. David Knopman, Neurology, Mayo Clinic, Rochester, Minnesota

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On the Mayo Clinic Radio podcast, Fredric Meyer, M.D., executive dean of education, Mayo Clinic School of Medicine, shares ideas and innovations that are transforming medical education and helping modernize training for tomorrow's doctors. Dr. Meyer is the Juanita Kious Waugh Executive Dean for Education. Also on the program, Dr. David Knopman, a neurologist at Mayo Clinic, discusses how lifestyle choices throughout your life can affect your risk of dementia. And Dr. Michael Ackerman, a pediatric cardiologist at Mayo Clinic, explains the heart rhythm condition known as long QT syndrome.

The post #MayoClinicRadio podcast: 9/16/17 appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Fredric Meyer, M.D., executive dean of education, Mayo Clinic, will share ideas and innovations that are transforming medical education and helping modernize training for tomorrow's doctors. Dr. Meyer is the Juanita Kious Waugh Executive Dean for Education. Also on the program, Dr. David Knopman, a neurologist at Mayo Clinic, will discuss how lifestyle choices throughout your life can affect your risk of dementia. And Dr. Michael Ackerman, a pediatric cardiologist at Mayo Clinic, will explain the heart rhythm condition known as long QT syndrome.

Here's your Mayo Clinic Radio podcast.

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Mayo Clinic School of Medicine

On the next Mayo Clinic Radio program, Fredric Meyer, M.D., executive dean of education, Mayo Clinic, will share ideas and innovations that are transforming medical education and helping modernize training for tomorrow's doctors. Dr. Meyer is the Juanita Kious Waugh Executive Dean for Education. Also on the program, Dr. David Knopman, a neurologist at Mayo Clinic, will discuss how lifestyle choices throughout your life can affect your risk of dementia. And Dr. Michael Ackerman, a pediatric cardiologist at Mayo Clinic, will explain the heart rhythm condition known as long QT syndrome.

To hear the program, find an affiliate in your area.

Follow #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

Access archived shows.

The post Mayo Clinic Radio: Transforming medical education appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Fredric Meyer, M.D., executive dean of education, Mayo Clinic, will share ideas and innovations that are transforming medical education and helping modernize training for tomorrow's doctors. Dr. Meyer is the Juanita Kious Waugh Executive Dean for Education. Also on the program, Dr. David Knopman, a neurologist at Mayo Clinic, will discuss how lifestyle choices throughout your life can affect your risk of dementia. And Dr. Michael Ackerman, a pediatric cardiologist at Mayo Clinic, will explain the heart rhythm condition known as long QT syndrome.

To hear the program, find an affiliate in your area.

Here is this week's Mayo Clinic Radio podcast.

Follow #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

Access archived shows.

The post Mayo Clinic Radio: Transforming medical education / lifestyle and dementia risk / long QT syndrome appeared first on Mayo Clinic News Network.

The fourth Tuesday in March is Diabetes Alert Day — a one-day wake-up call to inform the American public about the seriousness of diabetes, particularly when diabetes is left undiagnosed or untreated. On the Mayo Clinic Radio podcast, endocrinologist Dr. Robert Rizza discusses diagnosis, treatment and prevention of diabetes. Also on the podcast, neurologist Dr. David Knopman shares information on how the brain ages and what can be done to protect brain health. And Debbie Fuehrer, a counselor with Mayo Clinic's Integrative Medicine and Health Program, explains how hypnosis is used in the clinical setting.

The post #MayoClinicRadio Podcast: 3/25/17 appeared first on Mayo Clinic News Network.

Here's your Mayo Clinic Radio podcast.

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