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This secondary analysis investigated if participants with multiple risk factors for cognitive decline received greater benefits.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n \n We used a sample of dementia\u2010free participants (\n N<\/jats:italic>\n \u00a0=\u00a02692) from the Atherosclerosis Risk in Communities (ARIC) cohort to develop a predictive model for cognitive decline. The model was applied to baseline measures of ACHIEVE participants (\n N<\/jats:italic>\n \u00a0=\u00a0977) to estimate predicted risk. We tested an interaction between predicted risk and randomization to hearing intervention or health education control.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Among ACHIEVE participants in the top quartile of predicted risk, 3\u2010year cognitive decline in the hearing intervention was 61.6% (95% confidence interval [CI]: 33.7%\u201394.1%) slower than the control.<\/jats:p>\n <\/jats:sec>\n \n DISCUSSION<\/jats:title>\n The effect of hearing intervention on reducing 3\u2010year cognitive decline was greatest among individuals with multiple baseline risk factors associated with faster cognitive decline.<\/jats:p>\n Trial Registration: ClinicalTrials.gov Identifier: NCT03243422<\/jats:p>\n <\/jats:sec>\n \n Highlights<\/jats:title>\n \n \n \n The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) trial tested the effect of hearing intervention on cognitive decline.<\/jats:p>\n <\/jats:list-item>\n \n Participants were recruited from the Atherosclerosis Risk in Communities (ARIC) cohort or de novo from the local community.<\/jats:p>\n <\/jats:list-item>\n \n A 48% reduction in cognitive decline was observed in ARIC cohort participants.<\/jats:p>\n <\/jats:list-item>\n \n In this secondary analysis, there was an interaction between hearing intervention and predicted risk of cognitive decline.<\/jats:p>\n <\/jats:list-item>\n \n Among participants in the top quartile of predicted risk of cognitive decline, hearing intervention slowed cognitive decline by 62%.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/alz.70156","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T01:39:50Z","timestamp":1747273190000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Cognitive benefits of hearing intervention vary by risk of cognitive decline: A secondary analysis of the ACHIEVE 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