Clinical Interventions in Aging (Dec 2023)
Clinical Assessment Tools for the Detection of Cognitive Impairment and Hearing Loss in the Ageing Population: A Scoping Review
Abstract
Melanie A Ferguson,1– 3 Kento Nakano,4 Dona MP Jayakody1,3,4 1School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia; 2Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia; 3Centre for Ear Sciences, Medical School, University of Western Australia, Perth, Australia; 4Ear Science Institute Australia, Perth, AustraliaCorrespondence: Melanie A Ferguson, Curtin School of Allied Health, Kent Street, Bentley, Perth, 6102, Western Australia, Australia, Tel +61 8 6457 0572, Email [email protected]: There is a strong association between cognitive impairment and hearing loss, both highly prevalent in the ageing population. Early detection of both hearing loss and cognitive impairment is essential in the management of these conditions to ensure effective and informed decisions on healthcare. The main objective was to identify existing and emerging cognitive and auditory assessment tools used in clinical settings (eg, memory clinics, audiology clinics), which manage the ageing population.Methods: A scoping review of peer-reviewed publications and results were reported according to the PRISMA-ScR guidelines.Results: A total of 289 articles were selected for data extraction. The majority of studies (76.1%) were conducted in 2017 or later. Tests of global cognitive function (ie, Mini-Mental State Exam, Montreal Cognitive Assessment) were the most commonly used method to detect cognitive impairment in hearing healthcare settings. Behavioral hearing testing (ie, pure-tone audiometry) was the most commonly used method to detect hearing loss in cognitive healthcare settings. Objective, physiological measures were seldom used across disciplines.Conclusion: Preferences among clinicians for short, accessible tests likely explain the use of tests of global cognitive function and behavioral hearing tests. Rapidly evolving literature has identified inherent limitations of administering global cognitive function tests and pure-tone testing in an ageing population. Using electrophysiological measures as an adjunct to standard methods of assessment may provide more reliable information for clinical recommendations in those with cognitive and hearing impairment, and subsequently achieve better healthcare outcomes.Plain Language Summary: 1. Hearing loss in mid-life (45– 65 years) is the number one modifiable risk factor for dementia, therefore early detection of hearing loss and cognitive impairment are essential to manage both conditions effectively.2. Tests of global cognitive function (eg, MMSE, MOCA) were the most commonly used tests to detect cognitive impairment in hearing healthcare clinics.3. Pure-tone audiometry was the most commonly used test to detect hearing loss in cognitive healthcare settings.4. Objective electrophysiological measures can overcome difficulties in assessing cognition and hearing loss in people with dementia, and can be a useful adjunct to existing assessment tests.Keywords: hearing loss, cognition, assessment, ageing, early detection
