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

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


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

ACHIEVE Collaborative Research Group


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.

Journal Article Type Article
Acceptance Date Oct 22, 2023
Online Publication Date Dec 11, 2023
Publication Date 2024-03
Deposit Date Dec 12, 2023
Publicly Available Date Dec 12, 2023
Journal Alzheimer's & Dementia
Print ISSN 1552-5260
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 20
Issue 3
Pages 1671-1681
Keywords aging, cognition, dementia, hearing loss, mild cognitive impairment, neurocognitive evaluation, speech understanding
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