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.
LinJSO’ConnorERossomRCPerdueLAEckstromE. Screening for cognitive impairment in older adults: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2013;159(9):601-612.
5.
UhlmannRFLarsonEBReesTSKoepsellTDDuckertLG. Relationship of hearing impairment to dementia and cognitive dysfunction in older adults. JAMA. 1989;261(13):1916-1919.
6.
LoughreyDGKellyMEKelleyGABrennanSLawlorBA. Association of age-related hearing loss with cognitive function, cognitive impairment, and dementia: a systematic review and meta-analysis. JAMA Otolaryngol Head Neck Surg. 2018;144(2):115-126.
7.
VelayudhanLSeung-HoRRaczekM, et al. Review of brief cognitive tests for patients with suspected dementia. Int Psychogeriatr. 2014;26(8):1247-1262.
8.
TsoiKKChanJYHiraiHWWongSYKwokTC. Cognitive tests to detect dementia: a systematic review and meta-analysis. JAMA internal medicine. 2015;175(9):1450-1458.
9.
LonieJATierneyKMEbmeierKP. Screening for mild cognitive impairment: a systematic review. Int J Geriatr Psychiatry. 2009;24(9):902-915.
10.
PyeACharalambousAPLeroiIThodiCDawesP. Screening tools for the identification of dementia for adults with age-related acquired hearing or vision impairment: a scoping review. Int Psychogeriatr. 2017;29(11):1771-1784.
11.
WhitingPFRutjesAWWestwoodME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med. 2011;155(8):529-536.
12.
DealJABetzJYaffeK, et al. Hearing impairment and incident dementia and cognitive decline in older adults: the Health ABC Study. J Gerontol A Biol Sci Med Sci. 2017;72(5):703-709.
13.
LinFRYaffeKXiaJ, et al. Hearing loss and cognitive decline in older adults. JAMA Intern Med. 2013;173(4):293-299.
14.
DawesPCruickshanksKJFischerMEKleinBEKleinRNondahlDM. Hearing-aid use and long-term health outcomes: hearing handicap, mental health, social engagement, cognitive function, physical health, and mortality. Int J Audiol. 2015;54(11):838-844.
15.
LopesLDCMagaldiRMGandaraMERReisACBJacob-FilhoW. Prevalence of hearing impairment in patients with mild cognitive impairment. Dement Neuropsychol. 2007;1(3):253-259.
16.
JayakodyDMPFriedlandPLNelEMartinsRNAtlasMDSohrabiHR. Impact of cochlear implantation on cognitive functions of older adults: pilot test results. Otol Neurotol. 2017;38(8):e289-e295.
17.
JayakodyDMPFriedlandPLEikelboomRHMartinsRNSohrabiHR. A novel study on association between untreated hearing loss and cognitive functions of older adults: baseline non-verbal cognitive assessment results. Clin Otolaryngol. 2018;43(1):182-191.
18.
GatesGAGibbonsLEMcCurrySMCranePKFeeneyMPLarsonEB. Executive dysfunction and presbycusis in older persons with and without memory loss and dementia. Cogn Behav Neurol. 2010;23(4):218-223.
19.
GatesGAAndersonMLFeeneyMPMcCurrySMLarsonEB. Central auditory dysfunction in older persons with memory impairment or alzheimer dementia. Arch Otolaryngol Head Neck Surg. 2008;134(7):771-777.
20.
GatesGAKarzonRKGarciaP, et al. Auditory dysfunction in aging and senile dementia of the Alzheimer’s type. Arch Neurol. 1995;52(6):626-634.
21.
BoiRRaccaLCavalleroA, et al. Hearing loss and depressive symptoms in elderly patients. Geriatr Gerontol Int. 2012;12(3):440-445.
22.
HopperTSlaughterSEHodgettsBOstevikAIckertC. Hearing loss and cognitive-communication test performance of long-term care residents with dementia: effects of amplification. J Speech Lang Hear Res. 2016;59(6):1533-1542.
23.
MosnierIBebearJPMarxM, et al. Improvement of cognitive function after cochlear implantation in elderly patients. JAMA Otolaryngol Head Neck Surg. 2015;141(5):442-450.
24.
QuarantaNCoppolaFCasulliM, et al. The prevalence of peripheral and central hearing impairment and its relation to cognition in older adults. Audiol Neurootol. 2014;19(suppl 1):10-14.
25.
MosnierIVanierABonnardD, et al. Long-term cognitive prognosis of profoundly deaf older adults after hearing rehabilitation using cochlear implants. J Am Geriatr Soc. 2018;66(8):1553-1561.
26.
Ambert-DahanERoutierSMarotL, et al. Cognitive evaluation of cochlear implanted adults using CODEX and MoCA screening tests. Otol Neurotol. 2017;38(8):e282-e284.
27.
ChoiAYShimHJLeeSHYoonSWJooEJ. Is cognitive function in adults with hearing impairment improved by the use of hearing AIDS?Clin Exp Otorhinolaryngol. 2011;4(2):72-76.
28.
GieselerATahdenMAThielCMWagenerKCMeisMColoniusH. Auditory and non-auditory contributions for unaided speech recognition in noise as a function of hearing aid use. Front Psychol. 2017;8:219.
29.
MeisterHRahlmannSWalgerMMargolf-HacklSKiesslingJ. Hearing aid fitting in older persons with hearing impairment: the influence of cognitive function, age, and hearing loss on hearing aid benefit. Clin Interv Aging. 2015;10:435-443.
30.
VolterCGotzeLDazertSFalkensteinMThomasJP. Can cochlear implantation improve neurocognition in the aging population?Clin Interv Aging. 2018;13:701-712.
31.
LinFRFerrucciLMetterEJAnYZondermanABResnickSM. Hearing loss and cognition in the Baltimore Longitudinal Study of Aging. Neuropsychology. 2011;25(6):763-770.
32.
NguyenMFBonnefoyMAdraitA, et al. Efficacy of hearing aids on the cognitive status of patients with Alzheimer’s disease and hearing loss: a multicenter controlled randomized trial. J Alzheimers Dis. 2017;58(1):123-137.
33.
Harrison BushALListerJJLinFRBetzJEdwardsJD. Peripheral hearing and cognition: evidence from the Staying Keen in Later Life (SKILL) study. Ear Hear. 2015;36(4):395-407.
34.
DaviesHRCadarDHerbertAOrrellMSteptoeA. Hearing impairment and incident dementia: findings from the English Longitudinal Study of Ageing. J Am Geriatr Soc. 2017;65(9):2074-2081.
35.
HuhM. The relationships between cognitive function and hearing loss among the elderly. J Phys Ther Sci. 2018;30(1):174-176.
36.
KohDHLeeJDLeeHJ. Relationships among hearing loss, cognition and balance ability in community-dwelling older adults. J Phys Ther Sci. 2015;27(5):1539-1542.
37.
AdraitAPerrotXNguyenMF, et al. Do hearing aids influence behavioral and psychological symptoms of dementia and quality of life in hearing impaired Alzheimer’s disease patients and their caregivers?J Alzheimers Dis. 2017;58(1):109-121.
38.
AllenNHBurnsANewtonV, et al. The effects of improving hearing in dementia. Age Ageing. 2003;32(2):189-193.
39.
AkyiğitASubaşiBSakallioğluÖ, et al. Hearing levels in patients with Alzheimer’s dementia. Turk Geriatri Dergisi. 2014;17(3):285-289.
40.
FischerMECruickshanksKJNondahlDM, et al. Dichotic digits test performance across the ages: results from two large epidemiologic cohort studies. Ear Hear. 2017;38(3):314-320.
41.
AnsteyKJLuszczMAGilesLCAndrewsGR. Demographic, health, cognitive, and sensory variables as predictors of mortality in very old adults. Psychol Aging. 2001;16(1):3-11.
42.
BruckmannMPinheiroMM. Effects of hearing and cognitive impairment in sentence recognition. Codas. 2016;28(4):338-344.
43.
EastwoodMRCorbinSLReedMNobbsHKedwardHB. Acquired hearing loss and psychiatric illness: an estimate of prevalence and co-morbidity in a geriatric setting. Br J Psychiatry. 1985;147:552-556.
44.
FlatauESyndulkoKFlatauYOsterweilD. Hearing impairment in residents of a long-term care facility: prevalence and relationship to cognitive dysfunction. Ann Long Term Care. 1998;6(13):410-413.
45.
GatesGACobbJLLinnRTReesTWolfPAD’AgostinoRB. Central auditory dysfunction, cognitive dysfunction, and dementia in older people. Arch Otolaryngol Head Neck Surg. 1996;122(2):161-167.
46.
GoldMLightfootLAHnath-ChisolmT. Hearing loss in a memory disorders clinic: a specially vulnerable population. Arch Neurol. 1996;53(9):922-928.
47.
GopinathBMcMahonCMBurlutskyGMitchellP. Hearing and vision impairment and the 5-year incidence of falls in older adults. Age Ageing. 2016;45(3):409-414.
48.
HolderJTReynoldsSMSunderhausLWGiffordRH. Current profile of adults presenting for preoperative cochlear implant evaluation. Trends Hear. 2018;22:2331216518755288.
49.
KarpaMJGopinathBBeathK, et al. Associations between hearing impairment and mortality risk in older persons: the Blue Mountains Hearing Study. Ann Epidemiol. 2010;20(6):452-459.
50.
LimMYLLooJHY. Screening an elderly hearing impaired population for mild cognitive impairment using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Int J Geriatr Psychiatry. 2018;33(7):972-979.
51.
MoberlyACHoustonDMCastellanosI. Non-auditory neurocognitive skills contribute to speech recognition in adults with cochlear implants. Laryngoscope Investig Otolaryngol. 2016;1(6):154-162.
52.
MoberlyACPisoniDBHarrisMS. Visual working memory span in adults with cochlear implants: some preliminary findings. World J Otorhinolaryngol Head Neck Surg. 2017;3(4):224-230.
53.
MukariSZSIshakWSMaamorNWan HashimWF. A preliminary study investigating the association between hearing acuity and a screening cognitive tool. Ann Otol Rhinol Laryngol. 2017;126(10):697-705.
54.
NaramuraHNakanishiNTataraKIshiyamaMShiraishiHYamamotoA. Physical and mental correlates of hearing impairment in the elderly in Japan. Audiology. 1999;38(1):24-29.
55.
QianZJChangPDMoonisGLalwaniAK. A novel method of quantifying brain atrophy associated with age-related hearing loss. NeuroImage Clin. 2017;16:205-209.
56.
QianZJWattamwarKCaruanaFF, et al. Hearing aid use is associated with better Mini-Mental State Exam performance. Am J Geriatr Psychiatry. 2016;24(9):694-702.
57.
RonnbergJLunnerTNgEH, et al. Hearing impairment, cognition and speech understanding: exploratory factor analyses of a comprehensive test battery for a group of hearing aid users, the n200 study. Int J Audiol. 2016;55(11):623-642.
58.
SugawaraNSasakiAYasui-FurukoriN, et al. Hearing impairment and cognitive function among a community-dwelling population in Japan. Ann Gen Psychiatry. 2011;10(1):27.
59.
TayTKifleyALindleyR, et al. Are sensory and cognitive declines associated in older persons seeking aged care services? Findings from a pilot study. Ann Acad Med Singapore. 2006;35(4):254-259.
60.
TayTWangJJKifleyALindleyRNewallPMitchellP. Sensory and cognitive association in older persons: findings from an older Australian population. Gerontology. 2006;52(6):386-394.
61.
ValentjinSAvan BoxtelMPvan HoorenSA, et al. Change in sensory functioning predicts change in cognitive functioning: results from a 6-year follow-up in the Maastricht aging study. J Am Geriatr Soc. 2005;53(3):374-380.
62.
VilleneuveAHommetCAussedatCLescanneEReffetKBakhosD. Audiometric evaluation in patients with Alzheimer’s disease. Eur Arch Otorhinolaryngol. 2017;274(1):151-157.
63.
WongLLYuJKChanSSTongMC. Screening of cognitive function and hearing impairment in older adults: a preliminary study. Biomed Res Int. 2014;2014:867852.
64.
FischerMECruickshanksKJSchubertCR, et al. Age-related sensory impairments and risk of cognitive impairment. J Am Geriatr Soc. 2016;64(10):1981-1987.
65.
GusseklooJde CraenAJOduberCvan BoxtelMPWestendorpRG. Sensory impairment and cognitive functioning in oldest-old subjects: the Leiden 85+ Study. Am J Geriatr Psychiatry. 2005;13(9):781-786.
66.
ChisolmTHAbramsHBMcArdleRWilsonRHDoylePJ. The WHO-DAS II: psychometric properties in the measurement of functional health status in adults with acquired hearing loss. Trends Amplif. 2005;9(3):111-126.
67.
de CarvalhoLMGonsalezECIorioMC. Speech perception in noise in the elderly: interactions between cognitive performance, depressive symptoms, and education. Braz J Otorhinolaryngol. 2017;83(2):195-200.
68.
DealJAAlbertMSArnoldM, et al. A randomized feasibility pilot trial of hearing treatment for reducing cognitive decline: results from the Aging and Cognitive Health Evaluation in Elders Pilot Study. Alzheimers Dement (N Y). 2017;3(3):410-415.
69.
HelferKSJesseA. Lexical influences on competing speech perception in younger, middle-aged, and older adults. J Acoust Soc Am. 2015;138(1):363-376.
70.
HumesLEKiddGRLentzJJ. Auditory and cognitive factors underlying individual differences in aided speech-understanding among older adults. Front Syst Neurosci. 2013;7:55.
71.
KramerSVasilKJAdunkaOFPisoniDBMoberlyAC. Cognitive functions in adult cochlear implant users, cochlear implant candidates, and normal-hearing listeners. Laryngoscope Investig Otolaryngol. 2018;3(4):304-310.
72.
RonnbergJDanielssonHRudnerM, et al. Hearing loss is negatively related to episodic and semantic long-term memory but not to short-term memory. J Speech Lang Hear Res. 2011;54(2):705-726.
73.
van BoxtelMPvan BeijsterveldtCEHouxPJAnteunisLJMetsemakersJFJollesJ. Mild hearing impairment can reduce verbal memory performance in a healthy adult population. J Clin Exp Neuropsychol. 2000;22(1):147-154.
74.
UhlmannRFTeriLReesTSMozlowskiKJLarsonEB. Impact of mild to moderate hearing loss on mental status testing: comparability of standard and written Mini-Mental State Examinations. J Am Geriatr Soc. 1989;37(3):223-228.
75.
WongCGRapportLJBillingsBARamachandranVStachBA. Hearing loss and verbal memory assessment among older adults. Neuropsychology. 2019;33(1):47-59.
76.
AcarBYurekliMFBabademezMAKarabulutHKarasenRM. Effects of hearing aids on cognitive functions and depressive signs in elderly people. Arch Gerontol Geriatr. 2011;52(3):250-252.
77.
SheftSShafiroVWangEBarnesLLShahRC. Relationship between auditory and cognitive abilities in older adults. PLoS One. 2015;10(8):e0134330.
78.
HongTMitchellPBurlutskyGLiewGWangJJ. Visual impairment, hearing loss and cognitive function in an older population: longitudinal findings from the Blue Mountains Eye Study. PLoS One. 2016;11(1):e0147646.
79.
CastiglioneABenattiAVelarditaC, et al. Aging, cognitive decline and hearing loss: effects of auditory rehabilitation and training with hearing aids and cochlear implants on cognitive function and depression among older adults. Audiol Neurootol. 2016;21(suppl 1):21-28.
80.
ClaesAJde BackerSVan de HeyningPGillesAVan RompaeyVMertensG. Postoperative cognitive dysfunction after cochlear implantation. Eur Arch Otorhinolaryngol. 2018;275(6):1419-1427.
81.
SaundersGHOdgearICosgroveAFrederickMT. Impact of hearing loss and amplification on performance on a cognitive screening test. J Am Acad Audiol. 2018;29(7):648-655.
82.
DupuisKMarchukVPichora-FullerMK. Noise affects performance on the Montreal Cognitive Assessment. Can J Aging. 2016;35(3):298-307.
83.
ListerJJHarrison BushALAndelRMatthewsCMorganDEdwardsJD. Cortical auditory evoked responses of older adults with and without probable mild cognitive impairment. Clin Neurophysiol. 2016;127(2):1279-1287.
84.
EdwardsJDListerJJEliasMN, et al. Auditory processing of older adults with probable mild cognitive impairment. J Speech Lang Hear Res. 2017;60(5):1427-1435.
85.
DupuisKPichora-FullerMKChasteenALMarchukVSinghGSmithSL. Effects of hearing and vision impairments on the Montreal Cognitive Assessment. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2015;22(4):413-437.
86.
KarawaniHJenkinsKAndersonS. Restoration of sensory input may improve cognitive and neural function. Neuropsychologia. 2018;114:203-213.
87.
CosettiMKPinkstonJBFloresJM, et al. Neurocognitive testing and cochlear implantation: insights into performance in older adults. Clin Interv Aging. 2016;11:603-613.
88.
ClaesAJVan de HeyningPGillesAHofkens-Van den BrandtAVan RompaeyVMertensG. Impaired cognitive functioning in cochlear implant recipients over the age of 55 years: a cross-sectional study using the Repeatable Battery for the Assessment of Neuropsychological Status for Hearing-Impaired Individuals (RBANS-H). Front Neurosci. 2018;12:580.
89.
ClassonELöfkvistURudnerMRönnbergJ. Verbal fluency in adults with postlingually acquired hearing impairment. Speech Lang Hear. 2014;17(2):88-100.
90.
Lodeiro-FernandezLLorenzo-LopezLMasedaANunez-NaveiraLRodriguez-VillamilJLMillan-CalentiJC. The impact of hearing loss on language performance in older adults with different stages of cognitive function. Clin Interv Aging. 2015;10:695-702.
91.
VolterCGotzeLFalkensteinMDazertSThomasJP. Application of a computer-based neurocognitive assessment battery in the elderly with and without hearing loss. Clin Interv Aging. 2017;12:1681-1690.
92.
JorgensenLEPalmerCVPrattSEricksonKIMoncrieffD. The effect of decreased audibility on MMSE performance: a measure commonly used for diagnosing dementia. J Am Acad Audiol. 2016;27(4):311-323.
93.
FolsteinMFFolsteinSEMcHughPR. “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatric Res. 1975;12(3):189-198.
94.
NasreddineZSPhillipsNABedirianV, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53(4):695-699.
95.
LinVYChungJCallahanBL, et al. Development of cognitive screening test for the severely hearing impaired: hearing-impaired MoCA. Laryngoscope. 2017;127(suppl 1):S4-S11.
96.
DawesPPyeAReevesD, et al. Protocol for the development of versions of the Montreal Cognitive Assessment (MoCA) for people with hearing or vision impairment. BMJ Open. 2019;9(3):e026246.
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