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. 2022 Dec 13:13:1022292.
doi: 10.3389/fneur.2022.1022292. eCollection 2022.

Evaluation of the non-auditory neurocognitive test MoCA-HI for hearing-impaired

Christiane Völter  1 , Hannah Fricke  1 , Lisa Götze  1 , Franziska Labrenz  2 , Marianne Tokic  3 , Rainer Wirth  4 , Ziad S Nasreddine  5 , Piers Dawes  6
Affiliations

Evaluation of the non-auditory neurocognitive test MoCA-HI for hearing-impaired

Christiane Völter et al. Front Neurol. .

Abstract

Background: Since hearing loss and cognitive decline often co-occur among older adults, a cognitive screening test suitable for hearing-impaired people is of high clinical relevance. We report the first evaluation of a German language version of the Montreal Cognitive Assessment-Hearing Impaired version (MoCA-HI).

Objective: The aim of the present study was to compare cognitively healthy participants with and without hearing loss, to examine the impact of age, sex, educational level and degree of hearing impairment on the German MoCA-HI performance, and to develop normative data.

Material and methods: The German MoCA-HI was tested in 94 participants with normal or mild hearing impairment (group 1: 4PTA ≤ 40 dB on the better hearing ear) and 81 participants with moderate to profound hearing loss (group 2: 4PTA > 40 dB on the better hearing ear). Additionally, all participants performed the standard MoCA (version 8.2).

Results: No significant group difference between group 1 and 2 was found in the MoCA-HI total score (p = 0.05). In contrast, group 1 performed significantly better than group 2 on the standard MoCA (p < 0.001). There was no difference between the MoCA and the MoCA-HI performance in group 1 (p = 0.12), whereas individuals of group 2 performed significantly better on the MoCA-HI than on the standard MoCA (p < 0.001). Test-retest reliability of the MoCA-HI was high (p < 0.001). Higher age (p < 0.001), male sex (p = 0.009) and lower education (p < 0.001) were associated with a lower overall MoCA-HI score. Based on the demographic data normative data were developed by a regression-based approach.

Conclusion: The MoCA-HI is a cognitive screening test which is suitable for people with hearing impairment.

Keywords: MoCA; cognitive screening; dementia; hearing loss; test battery.

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Conflict of interest statement

CV has received reimbursement of scientific meeting participation fees and accommodation expenses, as well as honoraria for preparing continuing medical education events and funding for research projects that they initiated, from MED-EL. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Audiogram of group 1 and group 2. Testing was performed in the frequencies of 500, 1000, 2000 and 4000 Hz and graphs are shown for the mean sound pressure level in dB with the standard deviation on the better hearing ear.
Figure 2
Figure 2
Distribution of the adjusted MoCA-HI total score.
Figure 3
Figure 3
Example regression lines for the whole study sample (n = 175) representing the relationship of MoCA-HI total score with age, education and sex. Example regression lines are shown for subjects with 8 and 18 years of education. The regression model shows that the MoCA-HI total score was lower in case of less educational years, an increasing age and in male sex. Age had a stronger effect on the MoCA-HI total score in men than in women. 100 of the subjects included were aged between 60 and 71 years (males n = 59, females n = 41), 60 subjects between 72 and 83 years (males n = 33, females n = 27) and 15 subjects were aged 84 years or older (males n = 7, females n = 8).
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