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CompletedNCT03402932Updated Apr 3, 2019Results posted

Administration Method of Cognitive Screening in Older Individuals With Hearing Loss

An interventional study of Auditory amplified and Visual in Hearing Loss, Sensorineural and Cognitive Impairment, sponsored by Northwestern University. Completed at 1 site in United States. Open to participants aged 60 Years to 85 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2019-04-03.

Sponsored by Northwestern University · Not applicable, Interventional, and Screening

Phase
Not applicable
Study type
Interventional
Enrollment
37
Allocation
Randomized
Ages
60 Years to 85 Years
Sex
All
01

Study summary

The objectives of the current project aim to determine whether a more controlled amplification method or a visual administration has an effect on hearing impaired older individuals' cognitive test scores.

Read the detailed description

Aim 1 is to create a visually administered condition of a cognitive test and to validate this condition in comparison to the auditory administration. Data will be collected from younger individuals with normal hearing. Each younger individual is tested using both visual and auditory condition and the scores are compared across the two conditions. It is anticipated that the scores will not be significantly different between the two conditions.

Aim 2 is to examine the test condition effect on cognitive testing results in older individuals with hearing loss. The three test conditions include auditory unamplified, auditory amplified, and visual. Each older individual will be tested using two different test conditions. It is predicted the auditory amplified and visual administrations will alleviate the cognitive load associated with hearing difficulty and lead to improved performance on the test.

02

Conditions studied

  • Hearing Loss, Sensorineural
  • Cognitive Impairment
03

Who can participate

Ages eligible
60 Years to 85 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Have sensorineural hearing loss
  • Have normal or corrected-to-normal vision

Exclusion criteria

Exclusion Criteria:

  • Have conductive hearing loss;
  • Have history of otologic or neurologic disorders
  • Have dementia
  • Non-native speakers of English
04

Study design

Phase
Not applicable
Primary purpose
Screening
Allocation
Randomized
Intervention model
Crossover assignment
Masking
None (open label)
Enrollment
37 participants (actual)

Study arms

  • Experimental
    Auditory Amplified-Visual

    This arm is designed to test the contrast between auditory amplified and visual conditions.

    Other: Auditory amplified · Other: Visual

  • Experimental
    Auditory Amplified-Unamplified

    This arm is designed to test the contrast between auditory amplified and unamplified conditions.

    Other: Auditory amplified · Other: Auditory unamplified

  • Experimental
    Auditory Unamplified-Visual

    This arm is designed to test the contrast between auditory unamplified and visual conditions.

    Other: Visual · Other: Auditory unamplified

  • Other
    Younger control group

    This arm is designed to validate the visual version by comparing to the auditory version in a group of younger normal hearing controls.

    Other: Visual · Other: Auditory unamplified

Interventions

  • OtherAuditory amplified

    The cognitive test will be administered using a computer-based signal processing to amplify the instruction. The presentation level is customized to the individual's hearing thresholds.

  • OtherVisual

    The cognitive test will be administered visually by using timed computer slides.

  • OtherAuditory unamplified

    The cognitive test will be administered by using a generic presentation level that simulates a normal conversational level.

05

What researchers measure

Primary outcomes

  1. Cognitive Screening Results (Montreal Cognitive Assessment)

    The cognitive screening test of Montreal Cognitive Assessment (MoCA) was administered to 4 groups with different administration method conditions (see arms/groups table). MoCA is s standardized cognitive screening tool for mild cognitive impairment and dementia. The total score was used as outcome measure of this study and this score ranges from 0-30, with higher score being better performance.

    Time frame: The outcome measure was assessed immediately after the test. This applies to both conditions for all the arms.

Secondary outcomes

  1. Auditory Working Memory Performance

    Older individuals were presented with lists of words and instructed to repeat them back. After each word list, they had to recall the words.

    Time frame: The outcome measure will be assessed immediately after the test.

06

Results

Posted Apr 3, 2019

Participant flow

Participant flow — Overall Study
MilestoneGroup1: Auditory -Visual (Younger Adults w/ Normal Hearing)Group2: Amplified-Visual (Older Adults w/ Hearing Loss)Group3: Amplified-Unamplified (Older Adults w/ Hearing Loss)Group4: Visual-Unamplified (Older Adults w/ Hearing Loss)
Started13888
Completed13888
Not completed0000

Outcome measures

PrimaryCognitive Screening Results (Montreal Cognitive Assessment)

The cognitive screening test of Montreal Cognitive Assessment (MoCA) was administered to 4 groups with different administration method conditions (see arms/groups table). MoCA is s standardized cognitive screening tool for mild cognitive impairment and dementia. The total score was used as outcome measure of this study and this score ranges from 0-30, with higher score being better performance.

Time frame:
The outcome measure was assessed immediately after the test. This applies to both conditions for all the arms.
Reported as:
Mean · score on a scale
Cognitive Screening Results (Montreal Cognitive Assessment)
score on a scaleGroup1: Auditory Unamplified -Visual (Younger Adults)Group2: Amplified-Visual (Older Adults w/ Hearing Loss)Group3: Amplified-Unamplified (Older Adults w/ Hearing Loss)Group4: Visual-Unamplified (Older Adults w/ Hearing Loss)
Condition 128.69 ± 1.222.37 ± 2.8223.375 ± 2.3423 ± 2.82
Condition 228.30 ± 1.1323.5 ± 2.9124.125 ± 1.2622.12 ± 2.8
SecondaryAuditory Working Memory Performance

Older individuals were presented with lists of words and instructed to repeat them back. After each word list, they had to recall the words.

Time frame:
The outcome measure will be assessed immediately after the test.
Reported as:
Mean · percentage of correct recall
Auditory Working Memory Performance
percentage of correct recallGroup1: Younger Control (Auditory Unamplified - Visual)Group2: Auditory Amplified - VisualGroup3: Auditory Amplified - UnamplifiedGroup4: Auditory Unamplified - Visual
Condition 182.88 ± 6.772.3 ± 7.169.1 ± 8.257.5 ± 11.5
Condition 282.11 ± 7.666.9 ± 9.6664.5 ± 11.461.3 ± 14.5

Adverse events

Collected over The outcome measures are behavioral measures (e.g., cognitive screening test scores) and were collected within a short period of time (2 hours).. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Group1: Younger Auditory Unamplified - Visual———
Group2: Auditory Amplified - Visual———
Group3: Auditory Amplified - Unamplified———
Group4: Auditory Unamplified - Visual———

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Group1: Younger Control (Auditory Unamplified - Visual)Group2: Auditory Amplified - VisualGroup3: Auditory Amplified - UnamplifiedGroup4: Auditory Unamplified - VisualTotal
<=18 years00000
Between 18 and 65 years1300013
>=65 years088824
Age, Continuous
Age, Continuous(Years)Group1: Younger Control (Auditory Unamplified - Visual)Group2: Auditory Amplified - VisualGroup3: Auditory Amplified - UnamplifiedGroup4: Auditory Unamplified - VisualTotal
Mean22.69 ± 2.7877 ± 5.9173.37 ± 4.1273.75 ± 6.3528.5 ± 1.18
Sex: Female, Male
Sex: Female, Male(Participants)Group1: Younger Control (Auditory Unamplified - Visual)Group2: Auditory Amplified - VisualGroup3: Auditory Amplified - UnamplifiedGroup4: Auditory Unamplified - VisualTotal
Female1045524
Male343313
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Group1: Younger Control (Auditory Unamplified - Visual)Group2: Auditory Amplified - VisualGroup3: Auditory Amplified - UnamplifiedGroup4: Auditory Unamplified - VisualTotal
American Indian or Alaska Native00000
Asian00000
Native Hawaiian or Other Pacific Islander00000
Black or African American00000
White1288836
More than one race00000
Unknown or Not Reported10001
Region of Enrollment
Region of Enrollment(participants)Group1: Younger Control (Auditory Unamplified - Visual)Group2: Auditory Amplified - VisualGroup3: Auditory Amplified - UnamplifiedGroup4: Auditory Unamplified - VisualTotal
United States1388836
07

Study locations

1 site
  • Hearing Aid Laboratory
    Evanston, Illinois 60208, United States
08

References and documents

Publications

  • Jorgensen LE, Palmer CV, Pratt S, Erickson KI, Moncrieff D. The Effect of Decreased Audibility on MMSE Performance: A Measure Commonly Used for Diagnosing Dementia. J Am Acad Audiol. 2016 Apr;27(4):311-23. doi: 10.3766/jaaa.15006. PubMed 27115241 ↗
  • Guerreiro MJS, Van Gerven PWM. Disregarding hearing loss leads to overestimation of age-related cognitive decline. Neurobiol Aging. 2017 Aug;56:180-189. doi: 10.1016/j.neurobiolaging.2017.05.001. Epub 2017 May 10. PubMed 28559106 ↗
  • Lin FR, Yaffe K, Xia J, Xue QL, Harris TB, Purchase-Helzner E, Satterfield S, Ayonayon HN, Ferrucci L, Simonsick EM; Health ABC Study Group. Hearing loss and cognitive decline in older adults. JAMA Intern Med. 2013 Feb 25;173(4):293-9. doi: 10.1001/jamainternmed.2013.1868. PubMed 23337978 ↗
  • Dupuis K, Pichora-Fuller MK, Chasteen AL, Marchuk V, Singh G, Smith SL. Effects of hearing and vision impairments on the Montreal Cognitive Assessment. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2015;22(4):413-37. doi: 10.1080/13825585.2014.968084. Epub 2014 Oct 17. PubMed 25325767 ↗

Study documents

  • Statistical analysis plan · Nov 25, 2018
  • Study protocol · Feb 1, 2019

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Undecided — The results will be shared in the form of presentations and publications. Study protocol is available upon request.

09

Registry details

Key details

Study ID
NCT03402932
Lead sponsor
Northwestern University
Responsible party
Jing Shen (Research Assistant Professor, Northwestern University) — Principal investigator
First posted
Jan 18, 2018
Start date
Apr 1, 2018
Primary completion
Jul 10, 2018
Completion
Jul 10, 2018
Results posted
Apr 3, 2019
Last update
Apr 3, 2019

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Mar 2019. You cannot join it, but the record below documents what was studied.

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