Effects of simulated hearing loss on cognitive task performance: A scoping review

Hearing loss (HL) and cognitive decline often co-occur in older adults. Many cognitive tests are administered using spoken instructions or stimuli, potentially biasing test results. The current scoping review aimed to provide an overview of studies using simulated HL in cognitively healthy participants to investigate its isolated impact on cognitive test performance, uncover gaps in current research, and provide...

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✦ The floor

Discussion

Signed responses from readers of the wire.

✦ Clinical Takeaway ✦

Audiologists and neuropsychologists should be aware that cognitive tests using spoken stimuli may underestimate true cognitive ability in patients with hearing loss; consider ensuring audibility before interpreting scores.

✦ Why It Matters ✦

This review highlights a systematic source of bias in cognitive assessment that could lead to misdiagnosis of cognitive decline in hearing-impaired older adults, with implications for how audiology and neuropsychology practices collaborate.

✦ Key Points ✦

01Simulated hearing loss can artificially lower scores on cognitive tests that rely on spoken instructions or stimuli.
02Older adults are at greatest risk of cognitive test bias due to hearing loss.
03The review is scoping in nature, mapping the evidence landscape rather than performing a meta-analysis.
04Findings suggest a need for audibility checks before administering spoken cognitive assessments.
05Highlights cross-disciplinary concern between audiology and neuropsychology.

✦ Claims & Evidence ✦

ClaimEvidenceSupport

Simulated hearing loss negatively affects performance on cognitive tasks that use spoken instructions or stimuli.

studypartially supported

Cognitive test scores in older adults with hearing loss may reflect auditory access rather than true cognitive ability.

studypartially supported

✦ Research metadata ✦

PMID: 42531003
DOI: 10.1037/neu0001111.
Journal: Neuropsychology
Publication type: review
Evidence level: 2a
Population: Adults (primarily older adults) with simulated hearing loss undergoing cognitive testing
Intervention: Simulated hearing loss during cognitive task administration
Comparator: Normal hearing condition

Primary outcomes

Cognitive task performance scores under simulated hearing loss; Assessment of bias in neuropsychological testing due to auditory degradation

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