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Cognition and Hearing: Should This be Part of My Clinical Practice?

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1.  In a recent study focused on what patients think about their communication ability: Patients were unconcerned with cognition Only a few patient comments had to do with cognition Nearly 50% of comments about communication had to do with cognition All of the comments were about cognition.

2.  Communication draws on cognitive abilities in the following ways: If processing speed is reduced, word recognition will be slower Patients with executive function declines can only hear in quiet Most patients cannot remember what they heard for more than 10 minutes Cognitive ability is seldom taxed in everyday communication

3.  Mild cognitive impairment is defined as: The first stage of Alzheimer's disease A cognitive decline from a previous level of cognitive performance that does not interfere with independence A cognitive decline from a previous level of cognitive performance that affects independent living A change in cognition of more than 50%

4.  Previous work studying hearing loss and dementia has shown that: Hearing loss and dementia are unrelated Hearing loss causes dementia Patients with hearing loss who wear hearing aids will not develop dementia Untreated hearing loss is associated with a higher risk of dementia

5.  A good cognitive assessment tool will: Sample all major cognitive abilities, such as memory and attention. Be time efficient and easy to administer Be validated with good psychometric properties (e.g., sensitivity and specificity). All of the above

6.  The cognitive assessments reviewed in this talk: Are equally sensitive to dementia and mild cognitive impairment Are generally more sensitive to dementia than to mild cognitive impairment Should not be used to screen for mild cognitive impairment Can be used to screen for dementia, mild cognitive impairment, and depression

7.  Cognitive assessment scores are likely to be poorer when: The patient has a hearing loss The patient has hearing loss and a lower level of education The patient is meeting the clinician for the first time The patient is anxious about the test

8.  According to the U.S. Preventative Services Task Force: Current evidence is not sufficient to assess the balance of benefits and harms of screening for cognitive impairment Screening for cognitive impairment will be beneficial to patients, and should be implemented in clinical practice Screening for cognitive impairment may be detrimental to patients, and should only be completed by a psychologist or psychiatrist Screening for cognitive impairment is encouraged in any physician or allied health office

9.  Suggested care pathway choices after a failed cognitive assessment include: Psychiatrist Mental health counselor Primary care physician or geriatrician Occupational therapist

10.  After administering a cognitive assessment, the clinician should: Discuss results and provide clear next steps Not tell the patient about his or her results Wait to tell the patient about the results under they are confirmed by a retest Provide information about cognitive ability if the patient asks