Dissertations, Theses, and Capstone Projects

Date of Degree


Document Type

Capstone Project

Degree Name





Barbara E. Weinstein

Subject Categories

Speech and Hearing Science | Speech Pathology and Audiology


Dementia, audiological evaluation, hearing loss


Background: Dementia and hearing loss are both prevalent, age-related conditions and recent research has established a correlation between the two. Audiological evaluations of persons with dementia are important due to a likely comorbidity of dementia and hearing loss, the detrimental effect that hearing loss has on cognition and cognitive tests, and because the similar presentation of the two conditions can cause hearing loss to be overlooked. Hearing loss intervention is critical for this population due to the positive effects that amplification has on cognition, social engagement, and listening effort. Despite the importance of hearing assessment and intervention, audiological evaluation of this population can be difficult as cognitive limitations can preclude the ability of patients to participate in behavioral testing used to measure hearing.

Objective: The purpose of this systematic review is to collect the available literature pertaining to the audiological evaluation of persons with dementia. The specific aims are to determine the feasibility of testing persons with dementia and to determine if the literature provides practical testing modifications for this population. This can increase referrals of persons with dementia for hearing assessments and can increase awareness of testing this population among audiologists.

Methods: A search of the CINAHL, Medline, PubMed, and Web of Science databases, accessible via the CUNY Graduate Center Mina Reese Library website, was conducted to identify relevant articles. Inclusion criteria was peer reviewed articles on the audiological assessment of adults with dementia that focused on components of a complete audiologic evaluation or hearing screening. Articles were excluded if they did not discuss the audiologic evaluation and if they were not published in English.

Results: Five articles met the inclusion criteria and were included in this systematic review. Two articles discussed pure tone threshold testing, three articles discussed hearing screenings, and two articles discussed speech testing among persons with dementia. Data was extracted from the articles to answer the research questions.

Discussion: The studies included in this review provided variable outcomes on the reliability and validity of audiologic results of persons with dementia. Suggested modification to the audiological evaluation when testing persons with dementia are discussed. The stage of dementia was shown to heavily influence the ability for persons with dementia to complete audiological testing and provide valid and reliable results. Since persons with dementia can be challenging to test, the simplest solution would be for physicians and other health care professionals to automatically refer patients to audiologists when they begin to evidence dementia symptoms. Early referrals to audiologists of patients in the initial dementia stages can circumvent the problem of testing difficulties and allow audiologists to successfully evaluate and treat patients’ hearing loss before their cognition significantly declines. Hearing loss intervention is an essential component in the management of persons with dementia as it can enhance cognition and social engagement and decrease listening effort and communication difficulties.

Conclusion: Persons with dementia experience significant challenges in their daily functioning that are exacerbated by the presence of untreated hearing loss. Audiologists are in a unique position to help persons with dementia by easing the additional burdens associated with hearing loss, thereby increasing their quality of life.