Montreal Cognitive Assessment Hearing Impairment (MoCA-H) in brazilian portuguese: performance analysis.
Larianny Rutzen Lazzari, Rochele Martins Machado, Karina Carlesso Pagliarin and 1 others
The MoCA-H in Brazilian Portuguese gave similar scores in 7 of 8 cognitive domains and the total score between 10 hearing-aid users and 10 normal-hearing elderly, but the hearing-aid group scored lower on the visuospatial/executive task (2.7 vs 3.9 out of 5).
Key findings
1In seven of the eight MoCA-H domains (naming, memory, attention, language, abstract reasoning, delayed recall, orientation) and in the total score, the two groups showed no statistically significant difference.
2The only significant difference was in the visuospatial/executive domain: the hearing-loss group averaged 2.7 (SD 0.8) versus 3.9 (SD 1.1) for the normal-hearing group, out of a maximum of 5 points (p = 0.012).
3The total MoCA-H score was 20.8 (SD 2.6) for the hearing-loss group and 23.1 (SD 4.2) for the normal-hearing group, out of 30 points, a difference that did not reach significance (p = 0.123).
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How it was doneWhat they found
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What it does not show
Only 10 people per group, recruited by convenience from two clinics in one state, so the result is very sensitive to a few individuals and cannot be generalised. All participants were neurologically healthy with no cognitive complaints; the study says nothing about how the MoCA-H performs in people who actually have cognitive impairment. Average schooling was 12.4 years (SD 5.9), above the Brazilian national average for adults, so the findings may not hold for less-educated older adults. The entire battery — audiometry, MMSE, and MoCA-H — was done in a single two-hour session, and the cognitive tests came last, raising the possibility of fatigue or impatience affecting scores. The hearing-loss group all used hearing aids; the study does not address how the MoCA-H would perform in untreated hearing loss. Cross-sectional design: one snapshot, no follow-up, no repeated testing to check stability.
Declared interests
Funded by the State of Rio Grande do Sul research foundation (FAPERGS, grant 95391.887.70765.23042025) and CAPES, a federal higher-education agency. No industry sponsorship or author conflicts of interest are declared.
The easy way to misread this
Do not read the visuospatial/executive difference (2.7 vs 3.9 out of 5, p = 0.012) as proof that hearing loss impairs visuospatial function — with only 10 people per group, a single significant result among eight comparisons is vulnerable to chance, and the authors themselves suggest task order, initial anxiety, or fatigue as more likely explanations. Likewise, the 2.3-point gap in total scores (20.8 vs 23.1 out of 30) did not reach significance (p = 0.123) and should not be treated as evidence of a meaningful bias in the instrument.
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