scholarly journals Effect of Reduced Audibility on Mini-Mental State Examination Scores

2019 ◽  
Vol 30 (10) ◽  
pp. 845-855
Author(s):  
Laura Gaeta ◽  
Jo Azzarello ◽  
Jonathan Baldwin ◽  
Carrie A. Ciro ◽  
Mary A. Hudson ◽  
...  
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Hearing Loss ◽  
Signal To Noise Ratio ◽  
Normal Hearing ◽  
Cognitive Status ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Matched Case ◽  
State Examination

AbstractThe interaction of audition and cognition has been of interest to researchers and clinicians, especially as the prevalence of hearing loss and cognitive decline increases with advancing age. Cognitive screening tests are commonly used to assess cognitive status in individuals reporting changes in memory or function or to monitor cognitive status over time. These assessments are administered verbally, so performance may be adversely affected by hearing loss. Previous research on the impact of reduced audibility on cognitive screening test scores has been limited to older adults with sensorineural hearing loss (SNHL) or young adults with normal hearing and simulated audibility loss. No comparisons have been conducted to determine whether age-related SNHL and its impact on cognitive screening tests is successfully modeled by audibility reduction.The purpose of this study was to examine the effects of reduced audibility on the Mini-Mental State Examination (MMSE), a common bedside cognitive screening instrument, by comparing performance of cognitively normal older adults with SNHL and young adults with normal hearing.A 1:1 gender-matched case–control design was used for this study.Thirty older adults (60–80 years old) with mild to moderately severe SNHL (cases) and 30 young adults (18–35 years old) with normal hearing (controls) served as participants for this study. Participants in both groups were selected for inclusion if their cognitive status was within normal limits on the Montreal Cognitive Assessment.Case participants were administered a recorded version of the MMSE in background noise at a signal-to-noise ratio of +25-dB SNR. Control participants were administered a digitally filtered version of the MMSE that reflected the loss of audibility (i.e., threshold elevation) of the matched case participant at a signal-to-noise ratio of +25-dB SNR. Performance on the MMSE was scored using standard criteria.Between-group analyses revealed no significant difference in the MMSE score. However, within-group analyses showed that education was a significant effect modifier for the case participants.Reduced audibility has a negative effect on MMSE score in cognitively intact participants, which contributes to and confirms the findings of earlier studies. The findings suggest that observed reductions in score on the MMSE were primarily due to loss of audibility of the test item. The negative effects of audibility loss may be greater in individuals who have lower levels of educational attainment. Higher levels of educational attainment may offset decreased performance on the MMSE because of reduced audibility. Failure to consider audibility and optimize communication when administering these assessments can lead to invalid results (e.g., false positives or missed information), misdiagnosis, and inappropriate recommendations for medication or intervention.

scholarly journals Using Cognitive Screening Tests in Audiology

2016 ◽  
Vol 25 (4) ◽  
pp. 319-331 ◽  
Author(s):  
Jing Shen ◽  
Melinda C. Anderson ◽  
Kathryn H. Arehart ◽  
Pamela E. Souza
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Health Care Professionals ◽  
The United States ◽  
Medical Intervention ◽  
Cognitive Status ◽  
Screening Tests ◽  
Cognitive Screening

Purpose The population of the United States is aging. Those older adults are living longer than ever and have an increased desire for social participation. As a result, audiologists are likely to see an increased demand for service by older clients whose communication difficulty is caused by a combination of hearing loss and cognitive impairment. For these individuals, early detection of mild cognitive impairment is critical for providing timely medical intervention and social support. Method This tutorial provides information about cognition of older adults, mild cognitive impairment, and cognitive screening tests, with the purpose of assisting audiologists in identifying and appropriately referring potential cases of cognitive impairment. Results Topics addressed also include how to administer cognitive screening tests on individuals with hearing loss, how to use test results in audiology practice, and the potential of using cognitive screening tests for evaluating the benefit of clinical interventions. Conclusions As health care professionals who serve the aging population, audiologists are likely to encounter cases of undiagnosed cognitive impairment. In order to provide timely referral for medical assistance as well as an optimized individual outcome of audiologic interventions, audiologists should be trained to recognize an abnormality in older clients' cognitive status.

Seeing the Talker's Face Improves Free Recall of Speech for Young Adults With Normal Hearing but Not Older Adults With Hearing Loss

2016 ◽  
Vol 59 (3) ◽  
pp. 590-599 ◽  
Author(s):  
Mary Rudner ◽  
Sushmit Mishra ◽  
Stefan Stenfelt ◽  
Thomas Lunner ◽  
Jerker Rönnberg
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Free Recall ◽  
Cognitive Processing ◽  
Signal To Noise Ratio ◽  
Recall Performance ◽  
Cognitive Task ◽  
Normal Hearing ◽  
Task Demands ◽  
Audiovisual Integration

Purpose Seeing the talker's face improves speech understanding in noise, possibly releasing resources for cognitive processing. We investigated whether it improves free recall of spoken two-digit numbers. Method Twenty younger adults with normal hearing and 24 older adults with hearing loss listened to and subsequently recalled lists of 13 two-digit numbers, with alternating male and female talkers. Lists were presented in quiet as well as in stationary and speech-like noise at a signal-to-noise ratio giving approximately 90% intelligibility. Amplification compensated for loss of audibility. Results Seeing the talker's face improved free recall performance for the younger but not the older group. Poorer performance in background noise was contingent on individual differences in working memory capacity. The effect of seeing the talker's face did not differ in quiet and noise. Conclusions We have argued that the absence of an effect of seeing the talker's face for older adults with hearing loss may be due to modulation of audiovisual integration mechanisms caused by an interaction between task demands and participant characteristics. In particular, we suggest that executive task demands and interindividual executive skills may play a key role in determining the benefit of seeing the talker's face during a speech-based cognitive task.

Intelligibility of British- and American-Accented Sentences for American Younger and Older Listeners with and without Hearing Loss

2020 ◽  
Author(s):  
Sadie Schilaty ◽  
Sarah Hargus Ferguson ◽  
Shae D. Morgan ◽  
Caroline Champougny
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Hearing Loss ◽  
Normal Hearing ◽  
Mixed Effects ◽  
English Speaker ◽  
Listening Condition ◽  
Accented Speech ◽  
Essentially Normal ◽  
Within Subjects

Abstract Background Older adults with hearing loss often report difficulty understanding British-accented speech, such as in television or movies, after having understood such speech in the past. A few studies have examined the intelligibility of various United States regional and non-U.S. varieties of English for American listeners, but only for young adults with normal hearing. Purpose This preliminary study sought to determine whether British-accented sentences were less intelligible than American-accented sentences for American younger and older adults with normal hearing and for older adults with hearing loss. Research Design A mixed-effects design, with talker accent and listening condition as within-subjects factors and listener group as a between-subjects factor. Study Sample Three listener groups consisting of 16 young adults with normal hearing, 15 older adults with essentially normal hearing, and 22 older adults with sloping sensorineural hearing loss. Data Collection and Analysis Sentences produced by one General American English speaker and one British English speaker were presented to listeners at 70 dB sound pressure level in quiet and in babble. Signal-to-noise ratios for the latter varied among the listener groups. Responses were typed into a textbox and saved on each trial. Effects of accent, listening condition, and listener group were assessed using linear mixed-effects models. Results American- and British-accented sentences were equally intelligible in quiet, but intelligibility in noise was lower for British-accented sentences than American-accented sentences. These intelligibility differences were similar for all three groups. Conclusion British-accented sentences were less intelligible than those produced by an American talker, but only in noise.

The Impact of Subjective and Objective Hearing Loss on Cognition and Memory in Older Adults

2015 ◽  
Vol 20 (2) ◽  
pp. 49-57 ◽  
Author(s):  
Yvonne Rogalski ◽  
Amy Rominger
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Reading Aloud ◽  
Cognitive Testing ◽  
Professional Collaboration ◽  
Cognitive Screening ◽  
Speech Language Pathologist ◽  
Text Passage ◽  
The Impact ◽  
Audiologic Evaluation

For this exploratory cross-disciplinary study, a speech-language pathologist and an audiologist collaborated to investigate the effects of objective and subjective hearing loss on cognition and memory in 11 older adults without hearing loss (OAs), 6 older adults with unaided hearing loss (HLOAs), and 16 young adults (YAs). All participants received cognitive testing and a complete audiologic evaluation including a subjective questionnaire about perceived hearing difficulty. Memory testing involved listening to or reading aloud a text passage then verbally recalling the information. Key findings revealed that objective hearing loss and subjective hearing loss were correlated and both were associated with a cognitive screening test. Potential clinical implications are discussed and include a need for more cross-professional collaboration in assessing older adults with hearing loss.

Self-Perceived Hearing Loss, Hearing-Help Seeking and Hearing Aid Adoption Among Older Adults in Malaysia

2018 ◽  
Vol 127 (11) ◽  
pp. 798-805 ◽  
Author(s):  
Siti Zamratol Mai Sarah Mukari ◽  
Wan Fazlina Wan Hashim
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Help Seeking ◽  
Hearing Aid ◽  
Pure Tone Audiometry ◽  
Cognitive Status ◽  
Community Dwelling ◽  
Hearing Level ◽  
Low Sensitivity ◽  
Single Question

Introduction: The aims of this study were to examine the validity of self-perceived hearing loss in detecting hearing loss and factors associated with self-perceived hearing loss and hearing-help seeking and to report hearing aid adoption among a group of community-dwelling older adults in Malaysia. Methods: A total of 301 older adults (⩾60 years of age) participating in a study on aging had their hearing tested using pure-tone audiometry. Self-perceived hearing loss was assessed using a single question. Sociodemographic profile, otologic history, and general cognitive status were also obtained. Results: A single question had low sensitivity in detecting actual hearing loss: 31.3% for 4-frequency average > 25 dBHL and 48.8% for 4-frequency average > 40 dBHL. Besides hearing level, history of otorrhea and tinnitus were factors that were associated with self-perceived hearing loss among older adults with at least mild hearing loss. Hearing-help-seeking behavior was not associated with any of the tested variables. The hearing aid adoption rate was 2.7% and 7.3% among participants with 4-frequency averages > 25 dBHL and > 40 dBHL, respectively. Conclusion: The underestimation of hearing loss in the majority of older adults in this study poses a potential barrier to hearing loss intervention.

scholarly journals Applicability of the Test of Variables of Attention – T.O.V.A in Brazilian adults

2018 ◽  
Vol 12 (4) ◽  
pp. 394-401 ◽  
Author(s):  
Cláudia M. Memória ◽  
Henrique C.S. Muela ◽  
Natália C. Moraes ◽  
Valéria A. Costa-Hong ◽  
Michel F. Machado ◽  
...  
Keyword(s):  
Performance Test ◽  
Digit Span ◽  
Screening Tests ◽  
Trail Making Test ◽  
Digit Symbol ◽  
Cognitive Screening ◽  
Or Education ◽  
Attentional Processes ◽  
Trail Making ◽  
State Examination

ABSTRACT The functioning of attention is complex, a primordial function in several cognitive processes and of great interest to neuropsychology. The Test of Variables of Attention (T.O.V.A) is a continuous computerized performance test that evaluates some attention components such as response time to a stimulus and errors due to inattention and impulsivity. Objective: 1) To evaluate the applicability of T.O.V.A in Brazilian adults; 2) To analyze the differences in performance between genders, age ranges, and levels of education; 3) To examine the association between T.O.V.A variables and other attention and cognitive screening tests. Methods: The T.O.V.A was applied to 63 healthy adults (24 to 78 years of age) who also underwent the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Digit Span and Digit Symbol (Wechsler Intelligence Scale for Adults – WAIS-III) and the Trail Making Test. Results: the T.O.V.A was little influenced by age or education, but was influenced by gender. The correlations between some T.O.V.A variables and the Digit Symbol and Trail Making test were weak (r-values between 0.2 and 0.4), but significant (p<0.05). There was no correlation with the Digit Span test. Conclusion: The T.O.V.A showed good applicability and proved adequate for evaluating attentional processes in adults.

scholarly journals 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

2016 ◽  
Vol 21 (Suppl. 1) ◽  
pp. 21-28 ◽  
Author(s):  
Alessandro Castiglione ◽  
Alice Benatti ◽  
Carmelita Velardita ◽  
Diego Favaro ◽  
Elisa Padoan ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Cognitive Decline ◽  
Cochlear Implants ◽  
Hearing Aids ◽  
Digit Span ◽  
Depression Scale ◽  
Cognitive Status ◽  
Long Term Memory ◽  
Auditory Rehabilitation

A growing interest in cognitive effects associated with speech and hearing processes is spreading throughout the scientific community essentially guided by evidence that central and peripheral hearing loss is associated with cognitive decline. For the present research, 125 participants older than 65 years of age (105 with hearing impairment and 20 with normal hearing) were enrolled, divided into 6 groups according to their degree of hearing loss and assessed to determine the effects of the treatment applied. Patients in our research program routinely undergo an extensive audiological and cognitive evaluation protocol providing results from the Digit Span test, Stroop color-word test, Montreal Cognitive Assessment and Geriatric Depression Scale, before and after rehabilitation. Data analysis was performed for a cross-sectional and longitudinal study of the outcomes for the different treatment groups. Each group demonstrated improvement after auditory rehabilitation or training on short- and long-term memory tasks, level of depression and cognitive status scores. Auditory rehabilitation by cochlear implants or hearing aids is effective also among older adults (median age of 74 years) with different degrees of hearing loss, and enables positive improvements in terms of social isolation, depression and cognitive performance.

Cognition in older adults with severe to profound sensorineural hearing loss compared to peers with normal hearing for age

2019 ◽  
Vol 59 (4) ◽  
pp. 254-262 ◽  
Author(s):  
Maria Huber ◽  
Sebastian Roesch ◽  
Belinda Pletzer ◽  
Julia Lukaschyk ◽  
Anke Lesinski-Schiedat ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Normal Hearing ◽  
Sensorineural Hearing

scholarly journals Masking Release in Children and Adults With Hearing Loss When Using Amplification

2016 ◽  
Vol 59 (1) ◽  
pp. 110-121 ◽  
Author(s):  
Marc Brennan ◽  
Ryan McCreery ◽  
Judy Kopun ◽  
Dawna Lewis ◽  
Joshua Alexander ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Signal To Noise Ratio ◽  
Hearing Aid ◽  
Normal Hearing ◽  
Noise Masking ◽  
Sentence Recognition ◽  
Hearing Status ◽  
Masking Release ◽  
Adults And Children ◽  
Children With Hearing Loss

Purpose This study compared masking release for adults and children with normal hearing and hearing loss. For the participants with hearing loss, masking release using simulated hearing aid amplification with 2 different compression speeds (slow, fast) was compared. Method Sentence recognition in unmodulated noise was compared with recognition in modulated noise (masking release). Recognition was measured for participants with hearing loss using individualized amplification via the hearing-aid simulator. Results Adults with hearing loss showed greater masking release than the children with hearing loss. Average masking release was small (1 dB) and did not depend on hearing status. Masking release was comparable for slow and fast compression. Conclusions The use of amplification in this study contrasts with previous studies that did not use amplification. The results suggest that when differences in audibility are reduced, participants with hearing loss may be able to take advantage of dips in the noise levels, similar to participants with normal hearing. Although children required a more favorable signal-to-noise ratio than adults for both unmodulated and modulated noise, masking release was not statistically different. However, the ability to detect a difference may have been limited by the small amount of masking release observed.

Sign in / Sign up

Export Citation Format

Share Document