Development and validation of the Montreal cognitive assessment for people with hearing impairment (MoCA‐H)

Abstract

Background: Hearing impairment is common among older adults and affects cognitive assessments for identification of dementia which rely on good hearing function. We developed and validated a version of the Montreal Cognitive Assessment (MoCA) for people with hearing impairment.

Pure-tone audiometry and dichotic listening in primary progressive aphasia and Alzheimer’s disease

“…Secondly, it adds to the growing evidence base that the primary progressive aphasias are associated with complex auditory phenotypes that go beyond language (Goll et al, 2010; Grube et al, 2016; Hardy, Buckley, et al, 2016; Hardy et al, 2017, 2018; Jiang et al, 2022, 2023; Johnson, Jiang, et al, 2020; Utianski et al, 2019). Thirdly, it speaks to the importance of isolating cognitive tasks requiring speech perception for successful performance from those that do not, lending support to approaches to adapt existing cognitive measures to overcome the associated confounds (Al-Yawer et al, 2019; Dawes et al, 2023). Finally, it consolidates previous work suggesting that central hearing tests may hold utility as early biomarkers for neurodegenerative diseases such as Alzheimer’s disease and primary progressive aphasia (Gates et al, 2011; Hardy, Marshall, et al, 2016; Jiang et al, 2023; Johnson, Marshall, et al, 2020; Stevenson et al, 2021).…”

An Exploration of the Memory Performance in Older Adult Hearing Aid Users on the Integrated Digit-in-Noise Test

“…The test could take longer for individuals with cognitive, sensory, or perceptual impairments, such as hearing or visual loss. When good vision, hand–eye coordination, and auditory comprehension are needed, impairment of these functions could skew test results, overestimating cognitive decline ( Dawes et al, 2019 , 2023 ; Dupuis et al, 2015 ; Füllgrabe, 2020 ; Reischies & Geiselmann, 1997 ; Wittich et al, 2010 ). Adaptations of tests to account for a specific impairment, such as hearing or vision impairment versions of the MoCA ( Dawes et al, 2019 , 2023 ), do not address concurrent impairments, nor separate the effects of either.…”

“…In primary care settings, clinicians such as general practitioners, occupational therapists, and geriatricians without training in administering and interpreting relevant cognitive tests often face challenges in diagnosing cognitive decline in older adults ( Bradford et al, 2009 ; Langa & Levine, 2014 ; Yang et al, 2015 ), especially when its interaction with HL is ambiguous ( Dawes et al, 2023 ; Füllgrabe, 2020 ). In audiological clinical practice, assessing cognitive function in older adults exhibiting signs of potential cognitive decline may be appropriate ( Shen et al, 2016 ).…”

“…HL can complicate test administration due to potential misunderstandings of instructions and difficulties in speech recognition, causing an overestimation of cognitive decline, and resulting in false positive findings ( Dupuis et al, 2015 ; Füllgrabe, 2020 ; Jorgensen et al, 2016 ). While specialized versions of cognitive assessments, like the hearing or vision impairment versions of the Montreal Cognitive Assessment (MoCA; Dawes et al, 2019 , 2023 ; Lin et al, 2017 ), have been developed to lessen the impact of hearing or vision impairments on test outcomes by using only visual or auditory test signals, these adaptations could not address the needs of individuals with concurrent hearing and vision impairments, as a specific version cannot simultaneously address the effects of both hearing and vision impairments on test results. To address these challenges, this study proposes and preliminarily evaluates the integrated Digit-in-Noise Test (iDIN) for memory performance evaluation.…”

Screening for Dementia in Audiology Clinics – Advantages, Pitfalls, and Recommendations

“…People have tried to adapt cognitive screening tools for people with hearing impairment, but the reliability of these adapted tools for identifying cognitive impairment has typically not been established 12 or is inadequate. 13 A version of the MoCA has been adapted and validated for people with hearing impairment 14,15 and is freely available (mocacognition.com). Although the MoCA is free, users must register and either complete online training (at small cost) or be supervised by an appropriately qualified person (e.g., a clinical neuropsychologist).…”