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The multicentre, open-label CHOICE trial conducted in Shanghai randomized 703 adults aged ≥60 years with mild cognitive impairment (CDR global score 0.5) and moderate-to-severe hearing loss to binaural hearing aids (n=353) or structured hearing-care education (n=350). At 24 months, conversion to dementia-level impairment (CDR ≥1) occurred in 3.09% of the hearing-aid group versus 4.74% of the education group (RR 0.59, 95% CI 0.25–1.38; P=0.23), a non-significant difference. In a prespecified exploratory analysis, cognitive improvement (CDR shift from 0.5 to 0) was more frequent with hearing aids (15.34% vs 2.36%; RR 5.94, 95% CI 2.46–14.37; P<0.001), and the CDR memory domain also favoured the intervention. Serious adverse events were balanced (10 per group) and none were study-related. The trial did not show that hearing aids prevent progression to dementia-level impairment over 2 years, and the cognitive-improvement signal should be interpreted cautiously.
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The multicentre, open-label CHOICE trial conducted in Shanghai randomized 703 adults aged ≥60 years with mild cognitive impairment (CDR global score 0.5) and moderate-to-severe hearing loss to binaural hearing aids (n=353) or structured hearing-care education (n=350). At 24 months, conversion to dementia-level impairment (CDR ≥1) occurred in 3.09% of the hearing-aid group versus 4.74% of the education group (RR 0.59, 95% CI 0.25–1.38; P=0.23), a non-significant difference. In a prespecified exploratory analysis, cognitive improvement (CDR shift from 0.5 to 0) was more frequent with hearing aids (15.34% vs 2.36%; RR 5.94, 95% CI 2.46–14.37; P<0.001), and the CDR memory domain also favoured the intervention. Serious adverse events were balanced (10 per group) and none were study-related. The trial did not show that hearing aids prevent progression to dementia-level impairment over 2 years, and the cognitive-improvement signal should be interpreted cautiously.
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