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New study further supports that age-related hearing loss in patients taking cognitive tests may result in misdiagnoses of dementia

The early and correct diagnosis of a cognitive impairment – such as dementia – is crucial as it allows interventions and treatments that may slow the progression of a patient's symptoms to be quickly put in place.

However, a new study by Loughborough University researcher Dr Christian Füllgrabe further supports that age-related hearing loss can negatively affect the outcome of cognitive tests, resulting in misdiagnoses.

This is because many cognitive screening tests use auditory stimuli (presented orally by a clinician to a patient) for memory recall and people suspected of cognitive decline are typically older, and thus likely to also suffer from age-related hearing loss.

The question of the link between hearing loss and cognitive decline has been hotly debated in recent years, but the answer has been rather elusive.

Dr Füllgrabe’s latest paper further supports that hearing loss can lead to an overestimation of cognitive decline.

In his study, 56 young normal-hearing Loughborough University students with normal cognitive functions were asked to perform three memory tasks using speech stimuli that were either unmodified or modified to mimic age-related hearing loss.

Using participants without hearing impairments allowed Dr Füllgrabe to evaluate the acute effect of hearing loss during the cognitive test on test performance.

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Previous studies have used participants with actual hearing impairments but Dr Füllgrabe says as those suffering hearing loss are usually older, it can be hard to determine if the results are due to hearing loss or age-related changes in cognitive processing.

Dr Füllgrabe’s study conclusively demonstrated that memory performance was significantly lower in the group with the simulated hearing loss.

He says the findings are “strong evidence that the presentation format of the cognitive test can impact on the test performance”.

It is hoped the results will raise awareness of the issue and get clinicians to consider the possible impact of age-related hearing loss when interpreting cognitive test results.

Dr Füllgrabe, who works in the School of Sport, Exercise and Health Sciences, commented: “This new publication draws attention to the abusive interpretation that poor performance on a cognitive test necessarily indicates poor cognitive ability.

“As a frequent reviewer for numerous scientific journals and an associate editor of the International Journal of Audiology, I was well placed to witness that this issue was too often ignored.

“As explicitly advocated in the paper, I hope that, in the future, researchers and clinicians alike will consider the hearing status of their participants/patients when administering cognitive tests (such as those used for dementia screening) and interpreting their results.”

Dr Füllgrabe hopes to build on this research with Professor Eef Hogervorst (School of Sport, Exercise and Health Sciences, Loughborough University) and Dr Tobias Bast (Department of Psychology, University of Nottingham).

The researchers are hoping to use the same hearing-loss-simulation approach on a frequently used dementia screening test to help refine dementia diagnostics.

Dr Füllgrabe’s paper, titled ‘On the Possible Overestimation of Cognitive Decline: The Impact of Age-Related Hearing Loss on Cognitive-Test Performance’, can be read in its entirety here.

Notes for editors

Press release reference number: 20/124

Loughborough is one of the country’s leading universities, with an international reputation for research that matters, excellence in teaching, strong links with industry, and unrivalled achievement in sport and its underpinning academic disciplines.

It has been awarded five stars in the independent QS Stars university rating scheme, named the best university in the world for sports-related subjects in the 2020 QS World University Rankings and University of the Year by The Times and Sunday Times University Guide 2019.

Loughborough is in the top 10 of every national league table, being ranked 4th in the Guardian University League Table 2020, 5th in the Times and Sunday Times Good University Guide 2020 and 6th in The UK Complete University Guide 2021.

Loughborough is consistently ranked in the top twenty of UK universities in the Times Higher Education’s ‘table of tables’ and is in the top 10 in England for research intensity. In recognition of its contribution to the sector, Loughborough has been awarded seven Queen's Anniversary Prizes.

The Loughborough University London campus is based on the Queen Elizabeth Olympic Park and offers postgraduate and executive-level education, as well as research and enterprise opportunities. It is home to influential thought leaders, pioneering researchers and creative innovators who provide students with the highest quality of teaching and the very latest in modern thinking.