Abstract
BackgroundWith the evolving knowledge on hearing as a potentially modifiable mid-life risk factor for dementia, identification of people at risk becomes increasingly important. People with mild cognitive impairment (MCI) presenting to specialist memory services represent a key “at-risk” target population for audiological evaluation, but few services have established this pathway. This study sought to examine the patient experience and understanding of this process.MethodsAll patients with MCI attending a tertiary referral memory service referred for audiology review were contacted. A patient survey was delivered over the phone. Outpatient letters and the memory clinic database were reviewed.ResultsTwenty patients with MCI were included in the survey. Eight (8/20, 40%) had self-reported hearing loss. Upon formal audiological assessment seventeen (17/20, 85%) had objective evidence of hearing loss; nine (9/17, 52.9%) with mild-moderate and eight (8/17, 47%) with moderate-severe hearing loss. Only six patients (6/20, 30%) recalled having the rationale behind having a hearing test as part of their memory work-up explained to them. However, the majority (15/20, 75%) felt a hearing test was an important part of their memory assessment. Just seven patients overall (7/20, 35%) identified a link between hearing-loss and cognition. All patients who provided feedback on the service itself made positive comments, although (4/20, 20%) felt they did not get adequate information about the results.ConclusionsA significant proportion of people with MCI had de-novo evidence of hearing impairment upon assessment. Patients are satisfied with incorporating audiological evaluation into a memory clinic assessment, however clear communication around indication, recommendations, and follow-up ensuring compliance is required.
Highlights
With the evolving knowledge on hearing as a potentially modifiable mid-life risk factor for dementia, identification of people at risk becomes increasingly important
All patients diagnosed with mild cognitive impairment (MCI) are offered routine audiology referral since 2018, with the referral made on the basis of a cognitive diagnosis, rather than subjective hearing loss
Between October 2018 and January 2020, forty-five patients agreed to referral from the memory clinic to audiology assessment (Fig. 1), thirty had a diagnosis of MCI
Summary
With the evolving knowledge on hearing as a potentially modifiable mid-life risk factor for dementia, identification of people at risk becomes increasingly important. The number of people with dementia globally is rising [2], and with increasing knowledge of the risk factors involved, McDonough et al BMC Geriatrics (2021) 21:691 the focus is on disease modification for patients with dementia in the early stage or before symptoms present Targeting patients early, such as those with mild cognitive impairment (MCI), and optimizing their risk factor profile, could delay or even prevent the development of dementia, with significant personal and societal advantages resulting. People with dementia often lack insight into their hearing deficits and may have difficulties with audiology assessments and interventions [8] This highlights the importance of screening for hearing deficits in high-risk populations to identify patients most likely to benefit from intervention. Major public health issues such as hypertension, alcohol excess and obesity [2] are important mid-life risk factors for dementia and should be addressed to optimize a person’s risk factor profile and brain health
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