Cognitive Decline and Hearing Loss: The Importance of Assessment
Bibliographic record
Abstract
Hearing loss significantly compromises communication, social interaction, and multiple dimensions of quality of life. Furthermore, it is associated with an increased risk of cognitive decline, affecting processes such as memory, attention, language, and executive functions. The cognitive overload imposed by the effort required to understand speech in unfavorable acoustic conditions may anticipate or intensify neurodegenerative processes, particularly in older adults. Added to this is the impact of social isolation, reduced autonomy, and decreased participation in cognitively stimulating activities—factors that may mediate or accelerate this decline. In this context, the use of specific tools to assess cognition in individuals with hearing loss becomes essential, as tests that rely exclusively on the auditory modality tend to underestimate actual performance, leading to biased interpretations. To support healthcare professionals, particularly those in Speech-Language Pathology, Audiology, and Neuropsychology, this chapter presents the relationship between hearing loss and cognition, highlighting mechanisms, explanatory hypotheses, and recent epidemiological evidence. It also describes the instruments traditionally used in cognitive assessment and provides an in-depth discussion of specific tools developed or adapted for individuals with hearing impairment, introducing the Montreal Cognitive Assessment for Hearing Impairment (MoCA-H) as an appropriate instrument for these cases. By presenting these approaches, the chapter reinforces the importance of more precise assessment strategies that allow for reliable diagnoses, early identification of cognitive changes, and the planning of effective interventions. In doing so, it contributes to improving clinical practice and promoting integrated care that jointly considers both auditory and cognitive health.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".