Abstract
ObjectivesThis research aims to validate a modified visually based Montreal Cognitive Assessment for hearing-aid users (MoCA-HA). This population should be the target of cognitive screening due to high risk of developing dementia.DesignCase-control study.SettingThe participants were recruited from referral hearing-aid center and memory clinic in central London, United Kingdom.Participant75 hearing-aid users were recruited. Of these, thirty were cognitively intact controls with hearing impairment (NC-HI); thirty had mild cognitive impairment with hearing impairment (MCI-HI); fifteen had dementia with hearing impairment (D-HI).MeasurementsThe baseline characteristics and analysis of the MoCA-HA for the NC-HI were recorded. The MoCA-HA performance of the MCI-HI cohort and D-HI cohort were also studied.ResultsThe cutpoint of <26 yields 93.3% sensitivity with 80% specificity in distinguishing MCI-HI from NC-HI. The specificity increased to 95.6% in screening for all cognitive impairment (MCI-HI and D-HI) from NC-HI.ConclusionThe MoCA-HA has been validated with a cutpoint which is comparable to the traditional MoCA. This tool may help clinicians to early identify older adult hearing-aid users for appropriate cognitive evaluation.
Highlights
One in every three adults over the age of 65 suffer from disabling hearing loss (World Health Organization (WHO), 2012; WHO, 2018)
Diagnosis of dementia is critical in promoting positive patients outcomes (Prince et al, 2011), and the development of sensitive, valid and reliable dementia screening tools designed for a hearing-impaired population is of paramount importance
This study aims to expand upon Lin et al.’s work by examining the performance of the adapted Montreal cognitive assessment (MoCA) in older adults with no restriction of hearing loss severity
Summary
One in every three adults over the age of 65 suffer from disabling hearing loss (World Health Organization (WHO), 2012; WHO, 2018). A recent meta-analysis showed that hearing loss is a significant modifiable risk factor for dementia, with a pooled relative risk of 1.94 (95% CI [1.382.73]) (Livingston et al, 2017). These findings indicate that older adults with hearing loss should be targeted for cognitive screening as a high-risk population for dementia. Diagnosis of dementia is critical in promoting positive patients outcomes (Prince et al, 2011), and the development of sensitive, valid and reliable dementia screening tools designed for a hearing-impaired population is of paramount importance
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