A randomized clinical trial that enrolled only older adults who already had mild cognitive impairment (MCI) found that fitting them with hearing aids did not significantly reduce the proportion who progressed to dementia-level impairment over two years, researchers reported in JAMA Neurology on September 28, 2026. In the CHOICE trial, conducted at three otology clinics and three community health stations in Shanghai, China, 3.09 percent of participants given hearing aids progressed to dementia-level impairment within 24 months, compared with 4.74 percent of those who received hearing care and education without aids, a difference the researchers said was not statistically significant.
The trial was designed to answer a question left open by the earlier ACHIEVE trial, a larger US study published in 2023 that tested hearing intervention in a mixed population of older adults and found a benefit mainly in a subgroup already at higher risk for cognitive decline. CHOICE narrowed the design to only that subgroup: 703 adults age 60 or older with both moderate to severe hearing loss and a clinical diagnosis of MCI, drawn from 21,908 adults initially screened. Participants were randomly assigned to receive hearing aids or to a hearing care and education program that did not include aids, and were followed for 24 months, with the last participants completing follow-up in February 2026.
The trial's secondary results complicate a simple reading of the negative primary finding. Among participants who received hearing aids, 15.3 percent shifted from a Clinical Dementia Rating of 0.5, indicating mild impairment, back to a rating of 0, indicating no impairment, compared with 2.4 percent of those in the hearing care and education group. An editorial published the same day in JAMA Otolaryngology-Head and Neck Surgery, by Ruiyan Wang, Victoria Sanchez and Justin Golub, called the study important for testing hearing intervention specifically within the MCI population rather than a general older-adult sample, while noting that this reversal measure was a secondary outcome, not the trial's stated goal.
Because the study's primary, pre-specified outcome did not reach statistical significance, the trial does not establish that hearing aids prevent or reverse dementia. Researchers and the editorial authors describe the cognitive improvement finding as a secondary result that needs replication, in other settings and populations, before it can be treated as evidence of a treatment effect.