Staff Standpoint | January 2023 Hearing Review
This special edition was guest-edited by Douglas Beck AuD, and explores the history of cognition and the rapidly evolving research linking cognition and audition. Five industry experts will share insights into the HHCP’s changing role as a front-line caregiver uniquely situated to provide screening services to those suspected of suffering from cognitive decline.
By Kathryn Sutherland
2023: Perspectives and Review in Cognition and Audition
Douglas Beck, AuD, began his career in Los Angeles at the House Ear Institute in cochlear implant research and intraoperative cranial nerve monitoring. By 1988, he was director of audiology at Saint Louis University. In 1996 he co-founded a multi-office dispensing practice in St Louis. In 1999, he became President and Editor-In-Chief of AudiologyOnline.com, SpeechPathology.com, and HealthyHearing.com. He joined Oticon in 2005. From 2008 through 2015 he also served as Web Content Editor for the American Academy of Audiology (AAA). In 2016 he also became senior editor for clinical research at The Hearing Review and also, adjunct clinical professor of communication disorders & sciences at The State University of New York at Buffalo (SUNYAB). In 2019, he was appointed Vice President of Academic Sciences at Oticon Inc. Dr Beck is among the most prolific authors in audiology with more than 211 publications. He became Vice President of Clinical Sciences for Cognivue, Inc, Victor, NY in April 2022.
Beck reports, “Dementia globally will likely increase from an estimated 57 million cases in 2019 to approximately 153 million in 2050. Dementia, including Alzheimer’s disease (AD), kills more people than breast cancer and prostate cancer combined, and currently, one in three senior deaths is attributed to dementia. Dementias (including AD) will cost the nation $321 billion in 2022, and by 2050, the anticipated cost will be 1 trillion dollars.”
The Batteries Were Where?!
Jackie Clark, AuD, Doctor of Audiology Program, University of Texas at Dallas. She is a clinical professor at the University of Texas at Dallas School of Brain and Behavior Sciences and was appointed as a research scholar with the University of The Witwatersrand School of Speech and Hearing Therapy in Johannesburg, South Africa. She maintains her international research perspective by collaborating with universities globally and regularly consulting with the World Health Organization (WHO).
“Since audiologists would be more likely to encounter patients with behaviors consistent with mild cognitive impairment (MCI) in a typical clinic day, it is important to choose a validated pen and paper or electronic cognitive screening method that is easy for the patient to engage with as well as capture potential MCI by accurately tapping into the range of cognitive abilities: visuospatial, attention, working memory, language, short- term memory, and executive function. Once completed, each patient’s long-term care plan will be improved with greater patient-centered care and accuracy, and ultimately, their quality of life will be improved.”
Information Processing and Cognitive Audiology
Carolyn J Herbert, AuD, audiologist, DeVault Otologic Research Laboratory, Department of Otolaryngology-Head & Neck Surgery, Indiana University (IU) School of Medicine, Indianapolis, IN. She works closely with clinicians and research scientists at IU School of Medicine on a range of topics associated with hearing and listening in various populations, including pediatric and adult cochlear implant recipients and patients at risk for Alzheimer’s disease (AD).
David B Pisoni, PhD, distinguished professor of psychology and brain sciences and chancellor‚ professor of cognitive science; adjunct professor of speech, language, and hearing sciences and linguistics at Indiana University in Bloomington, IN; adjunct professor of otolaryngology-head & neck surgery, Indiana University School of Medicine, Indianapolis, IN. He has carried out seminal research on human speech perception, spoken word recognition, language processing, and perceptual development in infants and children for over 50 years.
“Focusing on cognition and brain function, a new interdisciplinary field of cognitive audiology has emerged recently, representing the intersection of clinicians, speech and hearing scientists, and cognitive psychologists. The core foundation of this collaboration is the information processing approach to cognition, which studies complex processes such as perception, attention, memory, learning, and thought, providing new insights into what is necessary for robust speech recognition and spoken language processing.”
Fundamentals in Screening in Mild Cognitive Disease
Barbara Weinstein, MA, Mphil, PhD, F-AAA, C-AAA, author of Geriatric Audiology, professor and founding executive officer, health sciences doctoral programs, doctor of audiology program, adjunct professor of medicine, NYU Langone Medical Center, and co-developer of the Hearing Handicap Inventory. Contributes practical and easy-to-apply assessment tools to help hearing health care practitioners (HHCPs) quickly screen patients for cognitive decline. She shares that having the ability to identify the modifiable risk factors along with early interventions could theoretically delay the onset of, and perhaps reduce, the economic costs of dementia. She earned her PhD from Columbia University where she began her academic career as a young faculty member and from which she was awarded the distinguished alumnus award in fall 2022. Her research on hearing loss, face masks during COVID-19, dementia, and social consequences of hearing loss, have had profound implications at the intersection of audiology, public health, and society.
“Given the high prevalence of hearing loss/difficulties among persons with mild neuro-cognitive disorder, the large and disproportionate weight attributed to hearing loss as potentially the largest modifiable risk factor for dementia onset according to the Lancet Commission report, and the sensory bias inherent in traditional cognitive tests administered orally, hearing health professionals can expect to see an increasing number of persons presenting with typical age-related decline in cognitive capacity, MCI, and diagnosed or undiagnosed dementia. Our case history should be holistic, with a focus on the whole person, including gaining an understanding of their self-perceived cognitive capacity and social/emotional/physical well-being.”
Dementia and the Hearing Healthcare Provider
Keith Darrow, PhD, CCC-A, Worcester State University. Worcester, MA; neuroscientist, clinical audiologist, director, and founder of the Hearing and Brain Centers of America and the Excellence in Audiology network. He is a renowned researcher and author focused on cutting-edge treatments for optimal brain health. In 2017 he wrote his first book, Stop Living in Isolation. His two most recent publications include statistical data and proven research on the most significant culprits behind cognitive decline and dementia, Preventing Decline and Don’t Let Them Live Without Hearing.
“The shift to integrating cognitive health into hearing healthcare was propelled by Lin and colleagues, who demonstrated the correlation of increased risk of cognitive decline and dementia with hearing loss, ie, the risk of cognitive decline and dementia increased an additional 130% per 10 dB drop in hearing. Additionally, the emerging relationship of speech-in-noise handicap with incident rates of dementia has compelled many HHCPs to begin screening for cognitive decline.”