Test Administration Methods and Cognitive Test Scores in Older Adults with Hearing Loss

In light of the high prevalence of hearing loss and cognitive impairment in the aging population, it is important to know how cognitive tests should be administered for older adults with hearing loss. The purpose of the present study is to examine this question with a cognitive screening test and a working memory test. Specifically, we asked the following questions in 2 experiments. First, does a controlled amplification method affect cognitive test scores? Second, does test modality (visual vs. auditory) impact cognitive test scores? Three test administration conditions were created for both Montreal Cognitive Assessment (MoCA) and working memory test (a word recognition and recall test): auditory amplified, auditory unamplified, and visual. The auditory administration was implemented through a computer program to control for presentation level while the visual condition was implemented through timed computer slides. Data were collected from older individuals with mild-to-moderate sensorineural hearing loss. We did not find any effect of amplification or test modality on the total score of the cognitive screening test (i.e., MoCA). Amplification improved working memory performance as measured by word recall performance, but test modality (auditory vs. visual) did not. These results are consistent with literature in demonstrating a downstream effect of audibility on working memory performance. From a clinical perspective, these findings are informative for developing clinical administration protocols of these tests for older individuals with hearing loss.