Whisper voice test for screening of hearing loss in nursing home residents with cognitive impairment

Whisper voice test for screening of hearing loss in nursing home residents with cognitive impairment

Main Article Content

Covadonga Vázquez-Sánchez
Luz Mª Gigirey

Abstract

Recent studies establish association between hearing loss and cognitive function and evidence exist that hearing damage can exacerbate the negative impact of cognitive impairment in quality of life. Prevalence of hearing loss increases among elderly people living in nursing homes, but the number of residents without hearing aids is high. Whisper voice test is a valid test for screening for hearing impairment. It is frequently used in Primary Care. We applied the voice test in older residents with cognitive impairment and we observed that these subjects failed the repetition of letters. Consequently, we decided to modify the habitual test procedure and employ familiar phrases as screening sound stimulus, on the assumption that they are more easily recognizable. The objective of our study is to establish whether this new technique can be used to screen for hearing loss in older people with mild-moderate cognitive impairment. 62 older residents (mini mental scores > 14) participated in this research. First results reveal that the voice test has high sensitivity and specificity, as well as elevated positive and negative predictive values. The proposed technique could be used as hearing screening tool in a population with similar characteristics.

References

Alattar, A.A., Bergstrom, J., Laughlin, G.A., Kritz-Silverstein, D., Richard, E.L., Reas, E.T., ... McEvoy, L.K. (2020). Hearing impairment and cognitive decline in older, community-dwelling adults. The Journals of Gerontology: Series A, 75(3), 567-573. https://doi.org/10.1093/gerona/glz035

Boatman, D.F., Miglioretti, D.L., Eberwein, C., Alidoost, M., y Reich, S.G. (2007). How accurate are bedside hearing tests?. Neurology, 68(16), 1311-1314. https://doi.org/10.1212/01.wnl.0000259524.08148.16

Ciorba, A., Bianchini, C., Pelucchi, S., y Pastore, A. (2012). The impact of hearing loss on the quality of life of elderly adults. Clinical interventions in aging, 7, 159. https://doi.org/10.2147/cia.s26059

Clark, J.G. (1981). Uses and abuses of hearing loss classification. ASHA, 23(7):493-500. https://pubmed.ncbi.nlm.nih.gov/7052898/

Dick, F. (2018). The whisper test and speech recognition tests. Occupational Medicine, 68(7),

-489. https://doi.org/10.1093/occmed/kqy069

Eekhof, J.A., de Bock, G.H., de Laat, J.A., Dap, R., Schaapveld, K., y Springer, M.P. (1996). The whispered voice: the best test for screening for hearing impairment in general practice? British Journal of General Practice, 46(409):473-474. http://www.ncbi.nlm.nih.gov/pubmed/8949327

Gates, G.A., Murphy, M., Rees, T.S., y Fraher, A. (2003). Screening for handicapping hearing loss in the elderly. Journal of Family Practice, 52(1):56-62. https://pubmed.ncbi.nlm.nih.gov/12540314/

Goman, A.M., Reed, N.S., y Lin, F.R. (2017). Addressing estimated hearing loss in adults in 2060. JAMA Otolaryngology–Head & Neck Surgery, 143(7), 733-734. https://doi.org/10.1001/jamaoto.2016.4642

International Organization for Standardization (2010). ISO 8253-1:2010. Acoustics — Audiometric test methods — Part 1: Pure-tone air and bone conduction audiometry. Recuperado de https://www.iso.org/standard/43601.html

Labanca, L., Sales F., Pimenta L., de Araújo E., y Utsch, D. (2017). Screening of hearing in elderly people: assessment of accuracy and reproducibility of the whispered voice test. Ciencia & saude coletiva, 22, 3589-3598. https://doi.org/10.1590/1413-812320172211.31222016

Leroi, I., Himmelsbach, I., Wolski, L., Littlejohn, J., Jury, F., Parker, A., ... y Thodi, C. (2019). Assessing and managing concurrent hearing, vision and cognitive impairments in older people: an international perspective from healthcare professionals. Age and ageing, 48(4), 580-587. https://doi.org/10.1093/ageing/afy183

Ley Orgánica 3/2018, de 5 de diciembre, de Protección de Datos Personales y garantía de los derechos digitales. Boletín Oficial del Estado, 294, de 6 de diciembre de 2018, 119788 a 119857. Recuperado de https://www.boe.es/eli/es/lo/2018/12/05/3/dof/spa/pdf

Lin, F.R., Metter, E.J., O’Brien, R.J., Resnick, S.M., Zonderman, A.B., y Ferrucci, L. (2011). Hearing loss and incident dementia. Archives of neurology, 68(2), 214-220. https://doi.org/10.1001/archneurol.2010.362

Macphee, G.J., Crowther, J.A., y McAlpine, C.H. (1988). A simple screening test for hearing impairment in elderly patients. Age Ageing, 17(5), 347-351. https://doi.org/10.1093/ageing/17.5.347

McCreedy, E.M., Weinstein, B.E., Chodosh, J., y Blustein, J. (2018). Hearing Loss: Why Does It Matter for Nursing Homes? Journal of the American Medical Directors Association, 19(4), 323-327. https://dx.doi.org/10.1016%2Fj.jamda.2017.12.007

McShefferty, D., Whitmer, W.M., Swan, I.R., y Akeroyd, M.A. (2013). The effect of experience on the sensitivity and specificity of the whispered voice test: a diagnostic accuracy study. BMJ open, 3(4), e002394. https://doi.org/10.1136/bmjopen-2012-002394

Pirozzo S, Papinczak T, y Glasziou P. (2003). Whispered voice test for screening for hearing impairment in adults and children: systematic review. BMJ, 327(7421), 967 https://www.ncbi.nlm.nih.gov/books/NBK69886/

Swan, I. R., y Browning, G. G. (1985). The whispered voice as a screening test for hearing impairment. Journal of Royal College of General Practitioners, 35(273), 197 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1960126/

Thomas, K.S., Dosa, D., Wysocki, A., y Mor, V. (2017). The minimum data set 3.0 cognitive function scale. Medical care, 55(9), e68 https://doi.org/10.1097/mlr.0000000000000334

Uhlmann, R.F., Rees, T.S., Psaty, B.M., Duckert, L.G. (1989). Validity and reliability of auditory screening tests in demented and non-demented older adults. Journal of General Internal Medicine, 4(2), 90-96. https://doi.org/10.1007/bf02602346

Wolski, L., Leroi, I., Regan, J., Dawes, P., Charalambous, A.P., Thodi, C., ... y Himmelsbach, I. (2019). The need for improved cognitive, hearing and vision assessments for older people with cognitive impairment: a qualitative study. BMC Geriatrics, 19(1), 328. https://doi.org/10.1186/s12877-019-1336-3

World Health Organization (2020). Deafness and Hearing loss. Recuperado de: https://www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss

Yamada, Y., Vlachova, M., Richter, T., Finne-Soveri, H., Gindin, J., van der Roest, H., … Topinkova, E. (2014) Prevalence and correlates of hearing and visual impairments in European nursing homes: Results from the SHELTER Study. Journal of the American Medical Directors Association, 15(10), 738-743. https://doi.org/10.1016/j.jamda.2014.05.012