Cognitive Screening of Adults With Postlingual Hearing Loss: A Systematic Review

Abstract

Objective To systematically review the evidence for the use of cognitive screening tools for adults with postlingual hearing loss. Data Sources PubMed, Embase, Scopus, PsycINFO (EBSCO), CINAHL (EBSCO), and CENTRAL (Cochrane Library) electronic databases were searched from inception until October 4, 2018. Review Methods Articles were reviewed for inclusion by 2 independent reviewers. The references of included articles were hand-searched for additional relevant articles. Data were extracted by 2 independent extractors. Results Of 2092 articles imported from the search, 81 were included for the review. Nearly a third (31%, n = 25) included patients with profound hearing loss. In total, 23 unique tools were used for 105 unique applications. The Mini Mental Status Exam (MMSE) was the most commonly used (54%, n = 55), followed by the Montreal Cognitive Assessment (MoCA) (19%, n = 10). Nearly half of the tools were used to define patient inclusion or exclusion in a study (48%, n = 50), followed by examination of a change after an intervention (26%, n = 27). Two articles attempted to study the validity of the MMSE and MoCA for screening patients with mild to moderate hearing loss and found mixed effects of the auditory components. There were no validation studies identified from the search. Conclusion Many different cognitive screening tools have been used to study patients with postlingual hearing loss. The effects of the auditory components of these tools may be deleterious but ultimately remain unclear from the available evidence. To date, there has been no validation of any cognitive screening tool to be used for adults with postlingual hearing loss.

Listening-Based Communication Ability in Adults With Hearing Loss: A Scoping Review of Existing Measures

“…A significant proportion of studies exploring cognition used screening measures, which have noted limitations as the primary form of assessment. Raymond et al (2020) systematic review of cognitive screening with adults with post-lingual hearing loss confirmed the frequent use of screening assessments such as the MMSE and the Montreal Cognitive Assessment (MoCA), both of which are reliant on auditory components. The authors note that based on the available evidence, these auditory components may have a deleterious effect on scores for adults with hearing loss.…”

“…Therefore, poor performance may be an indication of poor cognition, poor audibility for instruction, or increased effort for listening, which is known to impact working memory and recall ( Wayne et al, 2016 ). Adaptations to screening measures to adjust for auditory components have also proven problematic, as the removal and modification of items can directly influence the pass/fail status (sensitivity) ( Parada et al, 2020 ) and these modifications may not yet have been formally validated ( Dawes et al, 2019 ; Raymond et al, 2020 ).…”

Screening Tools and Assessment Methods of Cognitive Decline Associated With Age-Related Hearing Loss: A Review

“…However, a statistical survey of otolaryngologists and audiologists showed that the rate of cognitive function assessment for hearing loss patients was only 21.21% (Raymond et al, 2020 ), which indicates that the practice of cognitive assessment of high-risk groups, such as patients with ARHL, in clinical practice is not yet universal. This could be because the relationship between the two has not yet been popularized and further due to the lack of objective quantitative indicators with high sensitivity and specificity (Panza et al, 2015 ; Raymond et al, 2021 ). The development of electrophysiological technologies, such as EEG and MRI, provides the opportunity to achieve this goal.…”

Impact of Hearing Loss on Geriatric Assessment

“…[54][55][56][57] In the most frequently used neurocognitive screening batteries, the MMSE and the MoCA (Montreal Cognitive Assessment), 7 versus 10 out of 30 points depend on auditory presented stimuli, respectively. 47,48,58,59 This is also true for the DemTect, which is highly sensitive to (mild cognitive impairment) MCI detection and quite popular in Germany. 60 It consists of 5 subtests covering attention, (delayed) recall, transcoding of numbers, and language abilities and it has been validated in 363 patients with age-dependent cut-off scores.…”

“…After detailed full-text analysis, 21 articles dealing with the impact of hearing loss on cognitive testing were identified. One article was not available in full-text version, 46 two publications were reviews, 47,48 one was a review and a meta-analysis 49 and two were study protocols. 50,51 15 studies including participants of different age groups and hearing abilities were analyzed in detail (see Table 2).…”