Cognitive-Screening Practices Among Audiologists

By Sarah Black and Pamela Souza

This article is a part of the September/October 2020, Volume 32, Number 5, Audiology Today issue.

Cognition (i.e., the ability to reason, plan, remember, and direct tasks) has gained our professional attention, motivated in part by findings that hearing loss is associated with greater likelihood of cognitive decline (Lin et al, 2011; Lin et al, 2013) and is a major modifiable factor contributing to dementia risk (Livingston et al, 2017).

Providers within and outside audiology have asserted that screening and awareness of cognitive decline is within our scope of practice and should be part of treatment decisions (Valente et al, 2006; Remensnyder, 2012; Maslow and Fortinsky, 2018). Under-standing how an individual’s cognitive ability affects communication is also consistent with providing whole patient care (Taylor and Weinstein, 2015).

The goal of cognitive screening is to identify patients who may have mild cognitive impairment (MCI), a modest cognitive decline from previous performance that does not interfere with independence in everyday activities, or dementia, a severe decline that interferes with independence (American Psychiatric Association, 2013).

Several paths are open to providers, including making referrals for further evaluation when patients, family members, or the providers themselves note cognitive concerns during clinical care and/or formal screening whereby the need for referral can be determined in a quantitative way. Such practices are in widespread use in primary care (Alzheimer's Association, 2019; Raymond et al, 2020), but less common among audiologists (Martin et al, 2018). This article describes the results of a survey created to gain insight into how audiologists are responding to cognitive concerns in their patients.