A Comparison of Montreal Cognitive Assessment Scores among Individuals with Normal Hearing and Cochlear Implants.
Emily A Graves, Autefeh Sajjadi, Michelle L Hughes
PMID 38334699WHAT IT FOUND
Among 75 cochlear implant users and 74 normal-hearing adults, hearing-adjusted scoring on a common cognitive screen raised average scores but did not erase the gap.
The implant group still scored lower, and removing auditory items weakens the screen.
Key findings
01Across both groups, the hearing-adjusted method that removed all four auditory-dependent items produced the highest average score as a fraction of possible points (mean 0.938), and the method that removed digit span, letter attention, and sentence repetition produced the lowest (mean 0.892).
02The cochlear implant group scored lower than the normal-hearing group on average across all scoring methods (mean 0.938 vs 0.889), and the scoring method did not affect the two groups differently.
03For all four scoring methods, the normal-hearing group had the highest passing rate, the cochlear implant group had the next highest, and the hearing-loss group had the lowest.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The final comparison was age-matched only by removing the oldest cochlear implant participants, so it may not represent older cochlear implant users. The hearing-loss comparison group was not age-matched: the cochlear implant group averaged 61.2 years and the hearing-loss group averaged 73.6 years. The normal-hearing hearing screen was relaxed, and 59 of the 74 normal-hearing participants passed using the adjusted high-frequency criteria. Speech perception was not measured for the cochlear implant group, and amplification use was not reported for the hearing-loss group, so audibility differences may explain part of the score gap. Participants did not receive full follow-up cognitive evaluations, so lower MoCA scores may reflect test administration or true cognitive difficulty. Removing auditory items reduces the MoCA's psychometric properties, so adjusted scores should not be treated as equivalent to the standard screen. The normal-hearing group had more females and higher education than the cochlear implant group, which may have influenced scores.
Declared interests
The supplied publication types include NIH extramural research support. The supplied article text does not include a conflict-of-interest statement or say that a sponsor designed or wrote the study.
The easy way to misread this
Do not conclude that removing auditory MoCA items creates a valid hearing-adjusted cognitive screen for cochlear implant users. The adjusted scoring raised average scores, but the paper states that removing items significantly reduces sensitivity and is not recommended.