Diagnosis of dementia in hearing-impaired subjects using the MOCA-HI

As dementia diagnostic tools such as the MoCA screening test are mainly auditory-based, the risk of false-positive diagnosis in the presence of a moderate to severe hearing impairment cannot be ruled out. Therefore, a visual-based MoCA-HI has recently been developed in English. The aim of the present study was to assess a German version of the MoCA-HI in cognitive healthy subjects aged 60 or more with and without hearing loss.

After translation, the MoCA-HI was tested on 94 subjects with normal or slightly impaired hearing (NH) and on 81 subjects with moderate or severe hearing loss (SH) aged 60 to 97 (M: 71.52). Additionally, cognitive testing was performed with the standard MoCA and the GPCOG and socioeconomic as well as psychosocial data (GDS-15) were recorded. In 115 patients a retest was done after a period of at least 4 weeks.

A higher age (p<.001), male gender (p=.011), and lower education level (p<.001) were associated with a lower MoCA-HI total score. After accounting for these factors, no significant difference was found between NH and SH in the MoCA-HI total score (p=.550), the cognitive subdomains (p≥.494), or the three adapted items of the MoCA-HI (p≥.227). Retest reliability was high with a correlation of 0.844 (p<.001).

In the German MoCA-HI, the previously described difference between NH and SH could not be detected anymore. Currently, cognitively impaired normal hearing and hearing-impaired subjects are included in the study. The aim is to assess normative data adapted to age, gender and educational level, which allow to use the MoCA-HI in clinical practice in the long-term.

Publication History

Article published online:
24 May 2022