Self-Assessment Questions

This section provides a review. Mark each statement on the Answer Sheet according to the factual materials contained in this issue and the opinions of the authors.

Article One (pp. 111–121)

1. Which of the following cognitive tests would be expected to remain stable or improve with advancing age?

   • Speed of processing test

   • Working memory test

   • Vocabulary test

   • Divided attention test

   • Delayed free recall test

2. Which of the following biases found in clinical research would commonly overestimate the degree of cognitive decline seen with age?

   • Practice effect bias

   • Attrition bias

   • Recruitment bias

   • Misclassification bias

   • Survival bias

3. Which of the following cortical areas shows the most structural and functional changes with normal aging?

   • Primary motor cortex in the frontal lobe

   • Dorsal lateral prefrontal cortex

   • Primary visual cortex in the occipital lobe

   • Primary sensory cortex in the parietal lobe

   • Medial parietal lobe cortex

4. What percentage of the U.S. population age 85 years or older would be expected to have clinical signs of Alzheimer disease based upon published epidemiologic studies?

   • 45%

   • 20%

   • 15%

   • 10%

   • 5%

5. Which of the following diseases or conditions has been associated increased hippocampal atrophy on magnetic resonance imaging with age?

   • Diabetes

   • Major depression

   • Hypertension

   • Both A and C

   • All of the above

   Article Two (pp. 122–139)

6. Audiologists should consider social isolation when providing audiologic rehabilitation for older adults because

   • it is a predictor of mortality and declines in physical health

   • it is a predictor of mental health and cognitive and functional declines

   • hearing loss may contribute to social isolation

   • reduced social isolation is a positive outcome of rehabilitation

   • all of the above

7. Negative views of aging are related to

   • chronological age

   • size of social network

   • everyday functioning

   • lexical knowledge

   • highest level of education achievement

8. Based on epidemiologic studies, hearing loss in older adults has not been associated with

   • mortality

   • olfactory impairment

   • falls

   • depression

   • dementia

9. Cognitive reserve is greater for those who

   • have a higher IQ scores

   • have more education

   • have more physical exercise

   • eat a healthier diet

   • all of the above

10. Older volunteers in the Experience Corps program did not demonstrate

    • better speech-in-noise thresholds

    • faster walking speed

    • improved memory

    • increased social network size

    • increased prefrontal brain activity

    Article Three (pp. 149–149)

11. What contributes to misdiagnosis of mild cognitive impairment?

    • A reluctance of older adults to seek treatment or diagnosis of hearing loss

    • Lack of routine hearing aid usage

    • A tendency to bluff or pretend to hear questions or cognitive test prompts

    • All of the above

    • None of the above

12. Which mechanism suggests that agerelated changes have a central or neural component in addition to any peripheral or end organ source?

    • Overdiagnosis

    • Widespread neural degeneration

    • Sensory deprivation

    • Cognitive resource allocation

    • Social isolation

13. Early hearing loss diagnosis and treatment with amplification may help reduce the effects of which mechanism?

    • Overdiagnosis

    • Widespread neural degeneration

    • Sensory degradation/deprivation

    • Cognitive resource allocation

    • Social isolation

14. A degraded auditory signal can demand additional cognitive processing resources, resulting in

    • decreased working memory

    • difficulty recalling information

    • reduced cognitive spare capacity

    • A and B

    • A, B, and C

15. Adults with hearing loss are more likely than their peers with normal hearing to experience

    • smaller social networks

    • lower self-efficacy

    • depressive symptoms

    • anxiety

    • all of the above

    Article Four (pp. 150–161)

16. One of the universal findings in cognitive aging research is

    • reduced speed of information processing

    • reduced interest in new information

    • reduced ability to integrate new information

    • increased anxiety in communication situations

17. When controlling for hearing threshold levels and cognitive ability, a significant age effect is seen for

    • understanding speech in competing speech

    • time-compressed speech

    • binaural speech perception

    • all of the above

18. Gootjes et al found that in healthy elderly participants there was

    • significant positive correlation between ear asymmetry and corpus callosum size

    • significant negative correlation between ear asymmetry and corpus callosum size

    • no correlation between ear asymmetry and corpus callosum size

    • no way to compare ear asymmetry and corpus callosum size

19. Age-related effects on the P300 cognitive potential are reported in the literature. It is important to keep in mind that results are

    • highly variable

    • dependent on stimulus protocols

    • dependent on recording protocols

    • dependent on all of the above

20. Signal-to-noise ratio can be enhance through

    • decreasing noise

    • decreasing distance

    • decreasing reverberation

    • all of the above

    Article Five (pp. 162–174)

21. Which of the following hearing assistive technologies (HATs) would be appropriate for a person with severe dementia?

    • Personal sound amplification product

    • Hearing aid

    • Cochlear implant

    • Other assistive technology

    • All of the above are possible HATs depending on the person's need/support

22. Consistent and appropriate use of HATs for patients with cognitive impairment will potentially have which of the following effects?

    • Increased caregiver stress

    • Reduced caregiver stress

    • Increased patient anxiety

    • Reduced patient anxiety

    • B and D

23. Which of the following describes the relationship between hearing impairment and cognitive effort?

    • Those with hearing loss will have dementia, which causes increased cognitive effort.

    • Those with dementia will have hearing loss and cannot hear as well.

    • Those with hearing loss require more auditory attention and, therefore, increased cognitive load to perceive the auditory stimuli. This means that the cognitive system is working harder.

    • Dementia causes holes in the brain and the signals cannot be sent as efficiently.

    • There is no relationship.

24. Why is early identification and treatment of hearing loss preferred for the aging population?

    • Patients are more likely to experience better outcomes if they appropriately use HATs earlier in the aging process.

    • Buy-in of device use is better with younger people.

    • Younger people see doctors in higher regard than older people and thus are more likely to buy a HAT.

    • Less severe hearing losses are easier to fit.

    • Age of identification is not important.

25. Which of the following methods can an audiologist use to ensure that the HAT is fit and functioning appropriately for the patient with cognitive decline?

    • Loudness growth function

    • REAR/REIG (acoustic) or electrically evoked stapedial reflex threshold (electrical) verification measurements

    • Validation measurements

    • B and D

    • None of the above; HAT fit and function cannot be ensured for patients with cognitive decline

    Article Six (pp. 175–196)

26. The peripheral anatomy and physiology of the vestibular system are responsible for

    • sensing the degree acceleration

    • sensing the direction of acceleration

    • providing sense of orientation of the head with respect to gravity

    • all of the above

27. Fall-related injuries are estimated to cost how much annually?

    • $10 to 20 million

    • $50 to 60 million

    • $10 to 20 million

    • $50 to 60 million

28. According to The National Institute on Deafness and Other Communication Disorders, what proportion of the U.S. population is affected by a balance or vestibular disorder sometime during their lives?

    • One-quarter

    • One-half

    • Three-quarters

    • One-third

29. The majority of the histologic reports investigating vestibular hair cell degeneration confirm a general onset of significant hair cell decline at what age?

    • 45 to 50

    • 55 to 60

    • 65 to 70

    • 75 to 80

30. Balance function tests can be grossly divided into

    • tests that investigate the vestibular ocular reflex

    • tests that investigate the vestibular spinal reflex

    • tests that investigate the vestibular frontal reflex

    • A and B