Cognitive screening in hearing-impaired: Validation of the German MoCA-H

With increasing age, not only sensoric, but also cognitive abilities decline. However, most auditory-based cognitive test batteries cannot clearly distinguish between both. The recently developed Montreal Cognitive Assessment-H (MoCA-H), where two tests were replaced by non-auditory tasks in addition to visual instructions, is also suitable for hearing-impaired subjects. So far, reference data for a German-speaking study population is missing. 346 subjects aged≥60 (mean age 77.18 (SD 9.56)) with MCI (n=79) or with dementia (n=107) and without cognitive impairment (n=160) were included. Cognitive function was assessed using the GPCOG, a detailed medical questionnaire and a comprehensive examination by a neurologist in case of cognitive impairment. Cut-off values for normal cognition, MCI and dementia were determined using the balanced cut-off and the Youden's index. Subjects without cognitive impairment scored with 25.49 (SD 3.01), those with MCI with 20.08 (SD 2.29) and subjects with dementia with 15.8 (SD 3.85) points on average. A score of≤21 showed a sensitivity of 96.3% and a specificity of 90% to distinguish cognitive impairment from dementia. To detect MCI, a cut-off range between 22 and 24 points is recommended with a sensitivity of 97.5% and a specificity of 90%. The MoCA-H is a suitable screening test to distinguish cognitively healthy individuals from those with MCI or dementia. However, it cannot replace a comprehensive neuropsychiatric examination.

Publication History

Article published online:
19 April 2024