Cognitive-Processing Issues in Older Patients with ARHL

When serving our older patients, cognitive screenings may provide valuable insight into the listening and communication difficulties in complex environments. However, a recent study by Dr. Christian Füllgrabe (2020) suggests that the results of cognitive screenings may be impacted by the presence of age-related hearing loss (ARHL).

In his study, groups of young participants with normal-hearing sensitivity and no cognitive impairments were split into groups who listened to filtered and unfiltered stimuli to simulate ARHL. The group with the simulated ARHL had significantly poorer cognitive-test performance when compared to the group who listened to unfiltered stimuli.

Füllgrabe related the findings to work by Rabbitt (1968, 1991) who proposed the effortfulness hypothesis, which suggests that in challenging listening situations (i.e., hearing loss or background noise), speech recognition requires more effort. The increased effort limits the remaining cognitive resources and working memory necessary for speech recognition.

As a result, some cognitive screeners may overestimate the cognitive-processing issues in our older patients with ARHL. Future research will need to be conducted on cognitive screeners to determine how the impact of ARHL may be removed, this allowing for an accurate picture of a patient’s cognitive abilities.

References

Füllgrabe C. (2020) On the possible overestimation of cognitive decline: The impact of age-related hearing loss on cognitive-test performance. Frontiers in Neuroscience, 14, 454.

Rabbitt P. (1991) Mild hearing loss can cause apparent memory failures which increase with age and reduce with IQ. Acta Oto Laryngol. 111:167–176. doi: 10.3109/00016489109127274

Rabbitt PM A. (1968) Channel-capacity, intelligibility, and immediate memory. Q. J. Exp. Psychol. 20:241–248. doi: 10.1080/14640746808400158