Hearing aids in mild cognitive impairment: a two-year trial missed its main goal but found more cognitive improvement
A two-year randomized trial in China found that hearing aids did not significantly reduce progression from mild cognitive impairment to dementia-level impairment, though more people’s cognition improved.
Hearing loss is one of the strongest modifiable risk factors for dementia, but whether treating it protects the brain is still debated. A randomized trial published in JAMA Neurology on September 28, 2026, tested hearing aids in 703 adults aged 60 and older in Shanghai who had both mild cognitive impairment and moderate to severe hearing loss.
What the trial found
Participants received either hearing aids (353) or hearing-care education (350) and were followed for 24 months. Progression to dementia-level impairment was 3.1% with hearing aids and 4.7% with education, a difference that was not statistically significant, so the trial did not meet its primary goal.
In a prespecified secondary analysis, cognitive improvement back to a normal rating was more common with hearing aids, 15.3% versus 2.4%. There were no study-related adverse events. The trial was open-label, so participants knew which group they were in, which can influence ratings.
The larger ACHIEVE trial, in 977 adults aged 70 to 84 with untreated hearing loss, also did not slow cognitive decline overall, though benefit may appear in people at higher risk. The pattern across trials is promising but not yet conclusive.
What it means for you
Hearing aids improve communication and quality of life whatever their effect on dementia, and treating hearing loss is a reasonable step for brain health. Our Alzheimer’s prevention article covers the other modifiable risk factors.