A Hearing Intervention and Health-Related Quality of Life in Older Adults: A Secondary Analysis of the ACHIEVE Randomized Clinical Trial

Huang, Alison R.; Morales, Emmanuel Garcia; Arnold, Michelle L.; Burgard, Sheila; Couper, David; Deal, Jennifer A.; Glynn, Nancy W.; Gmelin, Theresa; Goman, Adele M.; Gravens-Mueller, Lisa; Hayden, Kathleen M.; Mitchell, Christine M.; Pankow, James S.; Pike, James R.; Reed, Nicholas S.; Sanchez, Victoria A.; Schrack, Jennifer A.; Sullivan, Kevin J.; Coresh, Josef; Lin, Frank R.; Chisolm, Theresa H.

Abstract

Importance
Health-related quality of life is a critical health outcome and a clinically important patient-reported outcome in clinical trials. Hearing loss is associated with poorer health-related quality-of-life in older adults.

Objective
To investigate the 3-year outcomes of hearing intervention vs health education control on health-related quality of life.

Design, Setting, and Participants
This secondary analysis of a randomized clinical trial included participants treated for hearing loss at multiple US centers between 2018 and 2019 with 3-year follow-up completed in 2022. Eligible participants were aged 70 to 84 years, had untreated hearing loss, and were without substantial cognitive impairment. Participants were randomized (1:1) to hearing intervention or health education control and followed every 6 months.

Intervention
Hearing intervention (provision of hearing aids and related technologies, counseling, education) or health education control (individual sessions covering topics relevant to chronic disease, disability prevention).

Main Outcomes and Measures
Three-year change in the RAND-36 physical and mental health component scores over 3 years. The 8 individual domains of health-related quality-of-life were additionally assessed. Outcomes measured at baseline and at 6-month, 1-year, 2-year, and 3-year follow-ups. Intervention effect sizes estimated using a 2-level linear mixed effects model under the intention-to-treat principle.

Results
A total of 977 participants were analyzed (mean [SD] age, 76.8 [4.0] years; 523 female [53.5%]; 112 Black [11.5%], 858 White [87.8%]; 521 had a Bachelor’s degree or higher [53.4%]), with 490 in the hearing intervention and 487 in the control group. Over 3 years, hearing intervention (vs health education control) had no significant association with physical (intervention, −0.49 [95% CI, −3.05 to 2.08]; control, −0.92 [95% CI, −3.39 to 1.55]; difference, 0.43 [95% CI, −0.64 to 1.51]) or mental (intervention, 0.38 [95% CI, −1.58 to 2.34]; control, −0.09 [95% CI, −1.99 to 1.81]; difference, 0.47 [95% CI, −0.41 to 1.35]) health-related quality of life.

Conclusions and Relevance
In this secondary analysis of a randomized clinical trial, hearing intervention had no association with physical and mental health-related quality-of-life over 3 years among older adults with hearing loss. Additional intervention strategies may be needed to modify health-related quality among older adults with hearing loss.

Citation

Huang, A. R., Morales, E. G., Arnold, M. L., Burgard, S., Couper, D., Deal, J. A., Glynn, N. W., Gmelin, T., Goman, A. M., Gravens-Mueller, L., Hayden, K. M., Mitchell, C. M., Pankow, J. S., Pike, J. R., Reed, N. S., Sanchez, V. A., Schrack, J. A., Sullivan, K. J., Coresh, J., Lin, F. R., & Chisolm, T. H. (2024). A Hearing Intervention and Health-Related Quality of Life in Older Adults: A Secondary Analysis of the ACHIEVE Randomized Clinical Trial. JAMA Network Open, 7(11), Article e2446591. https://doi.org/10.1001/jamanetworkopen.2024.46591

• Journal Article Type: Article
• Acceptance Date: Oct 1, 2024
• Online Publication Date: Nov 21, 2024
• Publication Date: 2024
• Deposit Date: Nov 26, 2024
• Publicly Available Date: Nov 26, 2024
• Journal: JAMA Network Open
• Electronic ISSN: 2574-3805
• Publisher: American Medical Association
• Peer Reviewed: Peer Reviewed
• Volume: 7
• Issue: 11
• Article Number: e2446591
• DOI: https://doi.org/10.1001/jamanetworkopen.2024.46591