The effect of hearing augmentation on cognitive assessment scales at admission to hospital

OBJECTIVES: : The aim was to assess how the use of a commercially available hearing augmentation device affected performance on cognitive assessment scales on admission to hospital.

DESIGN: : This was a randomized controlled trial.

SETTING: : The study was conducted on all of the acute assessment wards in a department of medicine for the elderly.

PARTICIPANTS: : All patients admitted to the department from December 1, 2007, until February 28, 2008, were considered for admission to the study. Patients with delirium were excluded.

INTERVENTION: : A commercially available device provided hearing augmentation in the intervention group on the second day.

MEASUREMENTS: : All participants had cognitive assessments using the Mini-Mental State Examination (MMSE) and the Abbreviated Mental Test (AMT) on two consecutive days.

RESULTS: : A total of 192 patients (60.4% women, mean [±SD] age 82.4 [±7.0] years) were recruited and randomized into control (N = 58) or intervention groups (N = 134). Paired and unpaired t-tests were used to compare mean improvements in scores within and between groups, respectively. The mean improvement in MMSE scores was 2.00 (p <0.001) in the intervention group and 0.49 in the control group (p = 0.46), and the mean improvement in AMT scores was 0.48 (p <0.001) for the intervention group and 0.24 (p = 0.04) for the control group. In comparing mean improvements between groups, unpaired t-test results were significant for MMSE (p <0.001) but not for AMT (p = 0.23). These results were confirmed on repeated-measures ANOVA (group by time interaction).

CONCLUSIONS: : Hearing augmentation significantly improves performance on MMSE scores. The use of hearing augmentation devices in routine screening for cognitive impairment merits further study.