Hearing loss and cognition: A protocol for ensuring speech understanding before neurocognitive assessment

Elizabeth R Kolberg; Emmanuel E Garcia Morales; Tara W Thallmayer; Michelle L Arnold; Sheila Burgard; Theresa H Chisolm; Josef Coresh; David Couper; Kathleen M Hayden; Alison R Huang; Frank R Lin; Christine M Mitchell; Thomas H Mosley; Lisa Gravens-Mueller; Tiffany A Owens; James S Pankow; James Russell Pike; Nicholas S Reed; Victoria Sanchez; Jennifer A Schrack; Jennifer A Deal; Adele M Goman; ACHIEVE Collaborative Research Group

doi:10.1002/alz.13552

Hearing loss and cognition: A protocol for ensuring speech understanding before neurocognitive assessment

Alzheimers Dement. 2024 Mar;20(3):1671-1681. doi: 10.1002/alz.13552. Epub 2023 Dec 11.

Authors

Elizabeth R Kolberg^{1

2}, Emmanuel E Garcia Morales^{1

3}, Tara W Thallmayer¹, Michelle L Arnold⁴, Sheila Burgard⁵, Theresa H Chisolm⁴, Josef Coresh^{3

6

7}, David Couper⁵, Kathleen M Hayden⁸, Alison R Huang^{1

3}, Frank R Lin^{1

2

3

9}, Christine M Mitchell^{1

3}, Thomas H Mosley¹⁰, Lisa Gravens-Mueller⁵, Tiffany A Owens¹⁰, James S Pankow¹¹, James Russell Pike^{5

12}, Nicholas S Reed^{1

3}, Victoria Sanchez⁴, Jennifer A Schrack³, Jennifer A Deal^{1

2

3}, Adele M Goman^{1

3

13}; ACHIEVE Collaborative Research Group

Affiliations

¹ Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
² Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
³ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
⁴ Department of Communication Sciences and Disorders, University of South Florida, Tampa, Florida, USA.
⁵ Collaborative Studies Coordinating Center, University of North Carolina, Chapel Hill, North Carolina, USA.
⁶ George W. Comstock Center for Public Health Research and Prevention, Johns Hopkins Bloomberg School of Public Health, Hagerstown, Maryland, USA.
⁷ Department of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
⁸ Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
⁹ Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
¹⁰ Memory Impairment and Neurodegenerative Dementia Center, University of Mississippi Medical Center, Jackson, Mississippi, USA.
¹¹ Division of Epidemiology, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.
¹² Department of Biostatistics, Gillings School of Global Public Health, Chapel Hill, North Carolina, USA.
¹³ School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK.

Abstract

Introduction: Many neurocognitive evaluations involve auditory stimuli, yet there are no standard testing guidelines for individuals with hearing loss. The ensuring speech understanding (ESU) test was developed to confirm speech understanding and determine whether hearing accommodations are necessary for neurocognitive testing.

Methods: Hearing was assessed using audiometry. The probability of ESU test failure by hearing status was estimated in 2679 participants (mean age: 81.4 ± 4.6 years) using multivariate logistic regression.

Results: Only 2.2% (N = 58) of participants failed the ESU test. The probability of failure increased with hearing loss severity; similar results were observed for those with and without mild cognitive impairment or dementia.

Discussion: The ESU test is appropriate for individuals who have variable degrees of hearing loss and cognitive function. This test can be used prior to neurocognitive testing to help reduce the risk of hearing loss and compromised auditory access to speech stimuli causing poorer performance on neurocognitive evaluation.

Keywords: aging; cognition; dementia; hearing loss; mild cognitive impairment; neurocognitive evaluation; speech understanding.

MeSH terms

Aged
Aged, 80 and over
Cognition
Cognitive Dysfunction* / diagnosis
Cognitive Dysfunction* / etiology
Hearing Loss* / complications
Hearing Loss* / diagnosis
Hearing Tests / adverse effects
Hearing Tests / methods
Humans
Speech

Abstract

MeSH terms

Grants and funding