For example, delivering the test with auditory amplification, has lead to the variability of results across cognitive sub-categories and omitting hearing-dependent items, has decreased the tool’s sensitivity for detecting cognitive impairment ( Saunders et al., 2018 Shen et al., 2019).Īnother possible way of MoCA modification is to adapt commonly used dementia screening tools for a visual as opposed to an auditory presentation. However, previously proposed modifications of the MoCA for its use in hearing-impaired populations tend to introduce new problems. The Montreal cognitive assessment (MoCA) has excellent validity in identifying mild cognitive impairment (MCI) compared to other commonly used screening tools ( Ciesielska et al., 2016 Kopecek et al., 2016). Timely 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. However, mishearing or misinterpreting the test instructions and test items due to hearing loss can lead to underestimations of cognitive ability ( Dupuis et al., 2015). Since current available screening tools for cognitive impairment require patients to follow orally presented instructions, normal hearing thresholds are implicitly assumed when conducting the test. These findings indicate that older adults with hearing loss should be targeted for cognitive screening as a high-risk population for dementia. 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 ) ( Livingston et al., 2017). One in every three adults over the age of 65 suffer from disabling hearing loss ( World Health Organization (WHO), 2012 WHO, 2018).

This tool may help clinicians to early identify older adult hearing-aid users for appropriate cognitive evaluation.

The specificity increased to 95.6% in screening for all cognitive impairment (MCI-HI and D-HI) from NC-HI.Ĭonclusion: The MoCA-HA has been validated with a cutpoint which is comparable to the traditional MoCA. Results: The cutpoint of <26 yields 93.3% sensitivity with 80% specificity in distinguishing MCI-HI from NC-HI. The MoCA-HA performance of the MCI-HI cohort and D-HI cohort were also studied. Measurements: The baseline characteristics and analysis of the MoCA-HA for the NC-HI were recorded. 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). Participant: 75 hearing-aid users were recruited. Setting: The participants were recruited from referral hearing-aid center and memory clinic in central London, United Kingdom. This population should be the target of cognitive screening due to high risk of developing dementia. Objectives: This research aims to validate a modified visually based Montreal Cognitive Assessment for hearing-aid users (MoCA-HA).

5NIHR Biomedical Research Centre Hearing and Deafness, London, United Kingdom.

4Division of Psychiatry, Faculty of Brain Sciences, University College London, London, United Kingdom.

3Division of Psychology and Language Science, Faculty of Brain Sciences, University College London, London, United Kingdom.

2Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

1UCL Ear Institute, London, United Kingdom.

Costafreda 4, Courtney North 3, Mary Heatley 3 and Doris Eva Bamiou 1,5 Nattawan Utoomprurkporn 1,2*, Joshua Stott 3, Sergi G.

Moca cognitive test