Application of a computer-based neurocognitive assessment battery in the elderly with and without hearing loss

Due to demographic changes, the number of people suffering not only from dementia illness but also from hearing impairment with the need for hearing rehabilitation have increased noticeably. Even with the association between hearing, age, and cognitive decline being well known, this issue has so far not played an important role in daily clinical Ear Nose Throat settings. The aim of the present study was to evaluate the use of a computer-based battery of tests of neurocognitive abilities in older patients with and without hearing loss.

A total of 120 patients aged 50 years and older were enrolled in this prospective clinical study: 40 patients suffered from severe bilateral hearing loss and were tested before cochlear implantation and 80 patients showed normal hearing thresholds between 500 and 4,000 Hz bilaterally. The test battery covered a wide range of cognitive abilities such as long- and short-term memory, working memory (WM), attention, inhibition, and other executive functions. Individuals with severe depression or cognitive impairment were excluded.

Hearing status was a significant predictor of performance on delayed recall (P=0.0082) and verbal fluency after adjusting for age (P=0.0016). Age predominantly impacted on inhibition (P=0.0039) and processing speed (P<0.0001), whereas WM measured by the Operation Span task (OSPAN) and the attention were influenced by both age and hearing. The battery of tests was feasible and practical for testing older patients without prior computer skills.

A computerized neurocognitive assessment battery may be a suitable tool for the elderly in clinical practice. While it cannot replace a thorough neuropsychological examination, it may help to draw the line between cognitive and hearing impairment in the elderly and enable the development of individual strategies for hearing rehabilitation.