(PP602) Hearing Loss, Cognition, Aging, and Cognivue: A Stakeholders Perspective

Hearing loss and dementia are highly prevalent neurologic conditions in older adults with considerable impact on quality of life. There is growing consensus for audiologists to screen older patients with hearing loss for cognitive decline. Congivue Thrive® is an FDA cleared, adaptable, computer-based, screening device for mild cognitive decline. This pilot study examines perceptions of stakeholders who will use this tool; patients and audiologists recruited from the community. All participants will complete the test and answer a questionnaire that probes their acceptance of cognitive screeners in an audiology practice. Stakeholders’ perspectives will be analyzed and reported as aggregate data.

Summary: 

Hearing loss is one of most common chronic conditions affecting adults > 65 years. By 2050, in the U. S., the number of people > 65 years with Alzheimer’s dementia is projected to reach 12.7 million. Hearing loss and dementia are both highly prevalent neurologic conditions in older adults, each with considerable impact on quality of life (Thomson et al., 2017). According to recent studies, age-related hearing loss may be a possible biomarker and/or modifiable risk factor for cognitive decline (Loughrey, et al., 2018; Wei et al, 2017).

There is growing consensus that audiologists should screen for cognitive decline to improve quality of life for older patients with hearing loss (Shen et al. 2016). There is less consensus on which screening tools to use and how to incorporate them in busy clinical practices. Many cognitive screening tests such as the Montreal Cognitive Assessment (MoCA) are generally administered orally to individuals who may have a hearing loss (Dupuis, 2015; Davis, 2021). Congivue Thrive® is an FDA cleared (2014) portable, adaptable, computer-based, self-administered screening device for mild cognitive decline. It does not use oral instructions, removing hearing loss as a confounding variable. In a clinical validation study with 100 participants, Congivue was reported to be as effective as the MoCA in identifying mild cognitive decline (Ma & Cahn-Hidalgo, 2021). Before using Congivue clinically, it is important to gauge the perspective of stakeholders; the patients and clinicians. The purpose of this pilot study is to examine the level of acceptance of older patients to undergo a cognitive screening at audiology clinics and willingness of clinicians to integrate a cognitive screener in audiology practices, taking into account equipment costs and extra time per appointment.

Congivue Thrive® assesses each patient’s motor skills and visual acuity to calibrate the test. It provides a report that scores for three cognitive domains; memory, executive function, and visuospatial abilities, and two performance parameters; processing speed and reaction time, all key to overall cognitive performance at any age. Seven patients between the ages of 65 and 80 years, with any degree of sensorineural hearing loss will be recruited from a university-based audiology clinic. The average time needed to complete Congivue Thrive® by patients will be computed. Patients will then complete a short questionnaire that will explore preferences for language considered non-stigmatizing, increasing acceptance for a cognitive screening test. Five clinicians will be recruited from the community who also will complete the test in order to personally experience this assessment. Clinicians will complete a different questionnaire assessing their perspective on whether audiologist should perform cognitive screening for older patients, and if so, would they use the Congivue Thrive®? In addition, clinicians will be asked if/how they would charge for the test and change the way they manage patients based on test outcomes. Stakeholders’ perspectives will be analyzed and reported as aggregate data. Automated cognitive screening tools may be easier to use clinically, allowing early detection of cognitive decline that could be mitigated with psychologic counseling and use of hearing aids.