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Otology/Neurotology

(223) Hearing Loss and Cognitive Errors in a Typical Otology Practice

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
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    Presenting Author(s)

  • Bryan J. Dooley, MD

    General Medical Officer
    Department of Otolaryngology-Head & Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland
    La Plata, Maryland, United States

    • Co-Author(s)

  • David S. Millay, MD

    Otolaryngology Resident
    Department of Otolaryngology-Head & Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland
    Gaithersburg, Maryland, United States

    • Senior Author(s)

  • AT

    Anthony M. Tolisano, MD

    Associate Program Director
    Department of Otolaryngology-Head & Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland
    Bethesda, Maryland, United States

Disclosure(s):
Bryan J. Dooley, MD: No relevant relationships to disclose.
David S. Millay, MD: No relevant relationships to disclose.
Anthony M. Tolisano, MD: No relevant relationships to disclose.


Introduction: Hearing loss is associated with dementia and cognitive impairment in older adults. To our knowledge, this association has not yet been validated within the cohort of a typical otology practice, the results of which would benefit pre-surgical expectation management and patient selection.

Methods: Consecutive adults presenting to an academic otology practice from June 2022 to September 2022 were screened for cognitive dysfunction utilizing the Cognitive Failures Questionnaire (CFQ). Patients were stratified as having serviceable hearing verses non-serviceable hearing through retrospective review of comprehensive audiograms and speech discrimination scores. 85 patients were eligible for inclusion. Non-serviceable hearing was defined for the worse hearing ear utilizing the 1995 AAO-HNS Hearing Class D category (speech discrimination score less than 50%). Univariate analysis was conducted via the Mann-Whitney U test, of which P less than 0.05 was considered statistically significant. GraphPad Prism version 9.4.1 was used for all analyses.

Results: Slightly more than half of subjects were male (56%) and median age (IQR) was 47 (38 - 58) years. There were 73 subjects with serviceable hearing and 12 with non-serviceable hearing. The median (IQR) CFQ total score was 27 (18 - 44) in subjects with serviceable hearing compared to 19 (11 - 29) in subjects with non-serviceable hearing, P=0.0843.

Conclusions: Our findings suggest that in contrast to the well-established association between age-related hearing loss and cognitive decline, within a typical otology practice degree of hearing loss is a poor predictor of cognitive dysfunction. Protective factors for this population likely include median age less than 50 and active engagement in otologic care, minimizing psychological distress symptoms closely correlated with self-reported cognitive errors.