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. 2024 Jan 8:17:1327759.
doi: 10.3389/fnins.2023.1327759. eCollection 2023.

Hearing loss, hearing aid use, and performance on the Montreal cognitive assessment (MoCA): findings from the HUNT study in Norway

Shahram Moradi  1   2 , Bo Engdahl  3 , Aud Johannessen  4   5 , Geir Selbæk  5   6   7 , Lisa Aarhus  8   9 , Gro Gade Haanes  4   10
Affiliations

Hearing loss, hearing aid use, and performance on the Montreal cognitive assessment (MoCA): findings from the HUNT study in Norway

Shahram Moradi et al. Front Neurosci. .

Abstract

Purpose: To evaluate the associations between hearing status and hearing aid use and performance on the Montreal Cognitive Assessment (MoCA) in older adults in a cross-sectional study in Norway.

Methods: This study utilized data from the fourth wave of the Trøndelag Health Study (HUNT4, 2017-2019). Hearing thresholds at frequencies of 0.5, 1, 2, and 4 kHz (or PTA4) in the better hearing ear were used to determine participants' hearing status [normal hearing (PTA4 hearing threshold, ≤ 15 dB), or slight (PTA4, 16-25 dB), mild (PTA4, 26-40 dB), moderate (PTA4, 41-55 dB), or severe (PTA4, ≥ 56 dB) hearing loss]. Both standard scoring and alternate MoCA scoring for people with hearing loss (deleting MoCA items that rely on auditory function) were used in data analysis. The analysis was adjusted for the confounders age, sex, education, and health covariates.

Results: The pattern of results for the alternate scoring was similar to that for standard scoring. Compared with the normal-hearing group, only individuals with moderate or severe hearing loss performed worse in the MoCA. In addition, people with slight hearing loss performed better in the MoCA than those with moderate or severe hearing loss. Within the hearing loss group, hearing aid use was associated with better performance in the MoCA. No interaction was observed between hearing aid use and participants' hearing status with performance on the MoCA test.

Conclusion: While hearing loss was associated with poorer performance in the MoCA, hearing aid use was found to be associated with better performance in the MoCA. Future randomized control trials are needed to further examine the efficacy of hearing aid use on the MoCA performance. When compared with standard scoring, the alternate MoCA scoring had no effect on the pattern of results.

Keywords: Montreal Cognitive Assessment (MoCA); cognitive decline; cognitive function; hearing aid use; hearing loss.

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Conflict of interest statement

The 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
Estimated marginal means of the Montreal Cognitive Assessment (standard scoring) as a function of hearing status. Estimates are averaged over categories of age, education, and sex at the means of the covariates of heart attack, heart failure, cancer, stroke, diabetes, smoking, and hospital admission for head injury. The error bars indicate 95% confidence intervals.
Figure 2
Figure 2
Estimated marginal means of the Montreal Cognitive Assessment (alternate scoring) as a function of hearing status. Estimates are averaged over categories of age, education, and sex at the means of the covariates of heart attack, heart failure, cancer, stroke, diabetes, smoking, and hospital admission for head injury. The error bars indicate 95% confidence intervals.
Figure 3
Figure 3
Estimated marginal means of the Montreal Cognitive Assessment (standard scoring) as a function of hearing status and hearing aid use. “Yes” in the figure refers to participants with hearing loss who used hearing aid and “No” refers to those who did not use hearing aid. Estimates are averaged over categories of age, education, and sex at the means of the covariates of heart attack, heart failure, cancer, stroke, diabetes, smoking, and hospital admission for head injury. The error bars indicate 95% confidence intervals.
Figure 4
Figure 4
Estimated marginal means of the Montreal Cognitive Assessment (alternate scoring) as a function of hearing status and hearing aid use. “Yes” in the figure refers to participants with hearing loss who used hearing aid and “No” refers to those who did not use hearing aid. Estimates are averaged over categories of age, education, and sex at the means of the covariates of heart attack, heart failure, cancer, stroke, diabetes, smoking, and hospital admission for head injury. The error bars indicate 95% confidence intervals.
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