A Hearing Screening at the Memory Clinic for Patients with Suspected Dementia

Abstract

Introduction: Although hearing impairment is recognized as a significant modifiable risk factor for dementia, no standardized methods or guidelines exist for hearing screening in cognitively impaired patients. The objectives of this study are to establish a suitable hearing assessment method at the memory clinic, compare the prevalence of hearing loss with a general population, and examine the relationship between hearing loss and the neuropsychological outcomes.

Methods: Participants included adult volunteers without hearing loss and cognitive impairment, patients from the audiology department with hearing loss but without cognitive impairment, and patients visiting the memory clinic for cognitive evaluation. Hearing screenings were included in the consultation hours of the memory clinic and were conducted using a word recognition test in free field and PTA serving as validation. The prevalence of hearing loss in the memory clinic population was compared to that of a general population of the same age. Neuropsychological test results were compared between patients with and without hearing
loss. Healthy subjects underwent free field word recognition tests at the memory clinic and in soundproof cabins to evaluate the influence of ambient sound. Patients from the audiology department were administered the free field word discrimination test at the memory clinic in order to investigate the influence of the cognitive component on the results of the hearing screening.

Results: Hearing loss was found in approximately half of the patients from the memory clinic. The results indicate a similar distribution of hearing loss prevalence between the memory clinic population and the general population. No statistically significant differences were found in neuropsychological test results between patients with and without hearing loss. Ambient sound at the memory clinic influenced the hearing screening results, but the cognitive component did not significantly impact the test outcomes. Strong correlations were observed between free field word recognition tests and PTA, as well as in test-retest results.

Discussion: Hearing loss is highly prevalent in the memory clinic population. The word recognition test in free field is an applicable, reliable, and efficient method for hearing screening at the memory clinic. Implementing a hearing screening at the memory clinic could enhance the neuropsychological examination process and enable early detection of hearing problems in patients unaware of their hearing impairment. Referrals to audiologists or ENT doctors and the use of hearing aids may potentially slow cognitive decline and reduce social isolation, loneliness, and depression. However, further research with a larger test population is necessary to validate these findings and investigate the impact of hearing loss treatment on cognitive function and the progression of cognitive decline.