Impact of Hearing Loss on Geriatric Assessment

Völter, Christiane; Götze, Lisa; Dazert, Stefan; Wirth, Rainer; Thomas, Jan Peter

doi:10.2147/cia.s281627

Cited by 25 publications

(24 citation statements)

References 111 publications

(141 reference statements)

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“…So far, only a few single-center studies have analyzed the long-term effects of cochlear implantation after one year ( Sarant et al, 2019 ; Huber et al, 2020 ). Few studies repeatedly evaluated speech perception, cognitive domains, and health-related QoL in the same participants to study the impact of auditory restoration on cognition ( Mosnier et al, 2015 , 2018 ; Völter et al, 2018 , 2020b ; Sarant et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

“…The close interaction between hearing loss and cognitive functions has gained attention of researchers recently ( Panza et al, 2019 ; Powell et al, 2021 ). On the one hand, neurocognitive functions have an impact on speech understanding, especially in challenging acoustic situations ( Rönnberg et al, 2013 ; Völter et al, 2020a , b ); on the other hand, several studies have pointed out the negative impact of hearing loss on cognition, both on a behavioral as well as on a neuroanatomic level ( Deal et al, 2015 ; Armstrong et al, 2020 ; Manno et al, 2021 ; Ren et al, 2021 ; Völter et al, 2021a ). A longitudinal study conducted by Lin in 2011 demonstrated that the risk of dementia within 11.9 years was elevated by 1.89 times in people with mild-hearing impairment, 3-fold in people with moderate hearing impairment, and by 4.94 times in people with severe hearing impairment ( Lin et al, 2011 ).…”

Section: Introductionmentioning

confidence: 99%

“…Despite promising results, the data are still conflicting not only due to the close association between hearing and cognition which influence each other in different ways, but also because of the study designs used ( Dawes, 2019 ; Moberly et al, 2019 ). Some protocols used auditory-based neurocognitive assessments, and therefore, limited understanding of the test material by subjects with severe hearing impairment cannot be ruled out ( Pye et al, 2017 ; Dawes, 2019 ; Utoomprurkporn et al, 2020 ; Völter et al, 2020b , 2021b ; Mertens et al, 2021 ; Raymond et al, 2021 ). Others only applied screening test instruments which might not be sensitive enough to detect slight differences ( Sonnet et al, 2017 ; Gurgel et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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Cognition and Cognitive Reserve in Cochlear Implant Recipients

Völter

Götze

Bajewski

et al. 2022

Front. Aging Neurosci.

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At present, dementia is a hot topic. Hearing loss is considered to be a modifiable risk factor for cognitive decline. The underlying mechanism remains unclear and might be mediated by socioeconomic and psychosocial factors. Cochlear implantation has been shown not only to restore auditory abilities, but also to decrease mental distress and to improve cognitive functions in people with severe hearing impairment. However, the promising results need to be confirmed. In a prospective single-center study, we tested the neurocognitive abilities of a large group of 71 subjects with bilateral severe hearing impairment with a mean age of 66.03 (SD = 9.15) preoperatively and 6, 12, and 24 months after cochlear implantation using a comprehensive non-auditory computer-based test battery, and we also assessed the cognitive reserve (CR) [Cognitive Reserve Index (CRI)], health-related quality of life (QoL) (Nijmegen Cochlear Implant Questionnaire), and depression (Geriatric Depression Scale-15). Cognitive functions significantly increased after 6 months in attention (p = 0.00004), working memory (operation span task; p = 0.002), and inhibition (p = 0.0002); and after 12 months in recall (p = 0.003) and verbal fluency (p = 0.0048), and remained stable up to 24 months (p ≥ 0.06). The CR positively correlated with cognitive functions pre- and post-operatively (both p < 0.005), but postoperative improvement in cognition was better in subjects with poor CR (p = 0.003). Depression had only a slight influence on one subtest. No correlation was found among cognitive skills, quality of life, and speech perception (each p ≥ 0.05). Cochlear implantation creates an enriched environment stimulating the plasticity of the brain with a global positive impact on neurocognitive functions, especially in subjects with poor preoperative cognitive performance and low cognitive reserve.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cognition and Cognitive Reserve in Cochlear Implant Recipients

Völter

Götze

Bajewski

et al. 2022

Front. Aging Neurosci.

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“…With regard to the person, a range of factors can affect engagement in the assessment process and influence their performance on testing. Age-related changes in hearing, vision, and processing speed, along with greater potential for fatigue may require some adjustment of assessment approaches and even modification of testing procedures (Lim & Loo, 2018; MacNeill & Lichtenberg, 1999; Mast & Gerstenecker, 2010; Völter et al, 2020). Moreover, some medical conditions that are more prevalent among older people such as arthritis and chronic pain can interfere with achieving optimal performance on testing.…”

Section: Foundational Knowledge For Practice With Older Adultsmentioning

confidence: 99%

Assessment: A foundational geropsychology knowledge competency.

Mast¹,

Fiske²,

Lichtenberg³

2022

Clinical Psychology: Science and Practice

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There is a pressing need for more psychologists trained to work with older adults. Up to 40% of psychologists report working with older adults, but relatively few report formal training. This review outlines foundational knowledge related to psychological assessment of older adults, including key principles of geropsychological assessment, introduction to relevant gerontological theories, discussion of research findings pertaining to core assessment domains (cognition, emotion, personality, and social relationships), and recommended assessment instruments. Two key risk assessment issues (diminished capacity and suicide risk) are explored in greater detail. Public Health Significance StatementThere is a pressing need for more psychologists trained to work with older adults. Knowledge of geropsychological theory and science are necessary for effective psychological assessment of older adults. A wide variety of psychological assessment instruments have been designed and validated for use with older adults.

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“…Others applied auditory-based test material which was not suitable for people with severe hearing loss ( 23 , 32 ). Despite authors' claim that audibility was ensured, misunderstanding cannot fully be excluded because verbally based cognitive tests may be influenced by auditory deprivation and can cause false positive results in up to 16% of tests ( 36 – 38 ).…”

Section: Introductionmentioning

confidence: 99%

Can cochlear implantation prevent cognitive decline in the long-term follow-up?

et al. 2022

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Cognitive function and hearing are known to both decline in older adults. As hearing loss is proposed to be one modifiable risk factor for dementia, the impact of auditory rehabilitation on cognitive decline has been gaining increasing attention. Despite a large number of studies, long-term data are still rare. In a large prospective longitudinal monocentric study, 50 adults (aged ≥ 50 years) with severe postlingual bilateral hearing loss received a cochlear implant (CI). They underwent comprehensive neurocognitive testing prior to implantation (T1), at 12 months (T2) and up to 65 months (T3) after implantation. Various cognitive subdomains such as attention, inhibition, working memory, verbal fluency, mental flexibility and (delayed) recall were assessed by the computer-based non-auditory test battery ALAcog©. The observed trajectories of two exemplary cognitive subdomains (delayed recall and working memory) were then fitted over time using multilevel growth models to adjust for sociodemographic covariates and compared with 5-year longitudinal data from a sample of older adults from the representative Survey of Health, Aging and Retirement in Europe (SHARE) study. Postoperatively, auditory functions improved from 6.98% (SD 12.83) to 57.29% (SD 20.18) in monosyllabic speech understanding. Cognitive functions significantly increased from T1 to T3 in attention (p = 0.001), delayed recall (p = 0.001), working memory (OSPAN; p = 0.001), verbal fluency (p = 0.004), and inhibition (p = 0.002). A closer look at follow-up revealed that cognitive improvement could be detected between T1 and T2 and thereafter remained stable in all subtests (p ≥ 0.06). Additional longitudinal analysis confirmed these findings in a rigorous multilevel approach in two exemplary cognitive subdomains. In contrast to the SHARE data, there was no evidence for age-differential associations over time in CI recipients. This suggests that older adults benefit equally from cochlear implantation. CI users with worse preoperative cognitive skills experienced the most benefit (p < 0.0001). Auditory rehabilitation by cochlear implantation has a stimulating effect on cognitive functions beyond an improvement in speech understanding and an increased well-being. Large multicenter studies using standardized protocols have to be undertaken in the future to find out whether hearing restoration might help to prevent cognitive decline.

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Impact of Hearing Loss on Geriatric Assessment

Cited by 25 publications

References 111 publications

Cognition and Cognitive Reserve in Cochlear Implant Recipients

Cognition and Cognitive Reserve in Cochlear Implant Recipients

Assessment: A foundational geropsychology knowledge competency.

Can cochlear implantation prevent cognitive decline in the long-term follow-up?

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