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P1‐650: COGNITIVE FRAILTY AND ADVERSE HEALTH OUTCOMES IN COMMUNITY‐DWELLING ELDERLY ADULTS: COMPARISON WITH PHYSICALLY FRAIL INDIVIDUALS WITHOUT COGNITIVE IMPAIRMENT
Author(s) -
Iijima Katsuya,
Tanaka Tomoki,
Toba Kenji,
Kozaki Koichi,
Akishita Masahiro
Publication year - 2018
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2018.06.662
Subject(s) - dementia , gerontology , cognition , medicine , cognitive decline , hazard ratio , confidence interval , physical therapy , psychiatry , disease
Background: Novel approaches to reduce the risk of age-related cognitive decline and Alzheimer’s disease and related dementias (ADRD) are urgently needed given the aging population. A recent Lancet Commission report of modifiable risk factors for ADRD concluded that, among all known modifiable risk factors for ADRD, hearing loss accounted for the greatest population attributable risk. Hypothesizedmechanistic pathways underlying this association include the effects of poor hearing and distorted peripheral encoding of sound on cognitive load, brain structure and function, and/or reduced social engagement. Determining whether hearing loss treatment could modify these pathways and reduce the risk of cognitive decline and ADRD will require a randomized trial. Methods: The ACHIEVE pilot study (n 1⁄4 40) and the design of the definitive ACHIEVE trial occurred from 2014-2016 with funding from an NIA clinical trial planning grant (R34AG046548). The full-scale ACHIEVE trial (N 1⁄4 850; R01AG055426) is now taking place and embedded within the Atherosclerosis Risk in Communities (ARIC) Study, an ongoing observational study of w16,000 adults who have been followed since 1987 in four U.S. communities. Results: ACHIEVE is a first-in-kind randomized trial that will investigate the effect of a hearing rehabilitative program versus a successful aging program on rates of cognitive decline (primary outcome), incident dementia, and physical and social functioning. The study will enroll 850 cognitively-normal older adults ages 7084 years withmild-to-moderate hearing loss whowill be randomized 1:1 to a hearing program (hearing needs assessment, fitting of devices, education/counseling) or successful aging program (individualized health education sessions covering healthy aging topics). Recruitment commenced in January 2018, and all participants will be followed for 3 years post-randomization to observe for rates of cognitive decline, incident ADRD, and other secondary outcomes. Conclusions:Given the high prevalence of hearing loss in older adults and the availability of hearing interventions that carry no risk, conducting the ACHIEVE randomized trial to determine whether existing hearing interventions can reduce the risk of cognitive decline and ADRD is of substantial public health importance.