Evaluation of the MoCA-HI in cognitive impaired patients

Introduction Hearing loss and cognitive impairment often occur simultaneously in old age. Most cognitive test batteries are auditory-based with the risk of false-positive results. Therefore, Dawes developed a non-auditory version of the original MoCA adapted for hearing-impaired with three different subtasks. This version has already been studied in cognitive healthy subjects. The aim of the study was to evaluate the German version of the MoCA-HI in cognitive impaired patients with and without hearing loss.

Material and Methods  81 patients without or with only a slight hearing loss (NH, 4PTAB ≤40dB) and 110 patients with a moderate or severe hearing loss (SH, 4PTAB >40dB) were included. 90 patients (81.88 years, SD6.56) had MCI (mild cognitive impairment) and 101 (83.47 years, SD6.38) showed the criteria of dementia according to the S3-DGN-guidelines. Further the GPCOG, a depression (GDS-15) and a stress (PSQ) questionnaire were applied and sociodemographics were assessed.

Results In the MoCA-HI total score, dementia patients (15.23, SD5.27) performed significantly worse than MCI patients (18.61, SD4.06) (p<.001). This was also true for all subtests except for the abstraction task, where two items have to be assigned to a common category and where no difference could be detected between MCI and dementia patients (p=.44). Hearing-impaired performed significantly better on the three subtasks of the MoCA-HI than on those of the original MoCA (p<.001), while this was not true for normal hearing subjects (p=.363).

Discussion The MoCA-HI test is a suitable screening tool for the detection of MCI or dementia in hearing-impaired and should replace the currently used MoCA in the clinical routine.

Publication History

Article published online:
12 May 2023