Listen Carefully protocol: an exploratory case-control study of the association between listening effort and cognitive function

Alix Feldman, François Patou, Monika Baumann, Anders Stockmarr, Gunhild Waldemar, Anja M Maier, Asmus Vogel, Alix Feldman, François Patou, Monika Baumann, Anders Stockmarr, Gunhild Waldemar, Anja M Maier, Asmus Vogel

Abstract

Introduction: A growing body of evidence suggests that hearing loss is a significant and potentially modifiable risk factor for cognitive impairment. Although the mechanisms underlying the associations between cognitive decline and hearing loss are unclear, listening effort has been posited as one of the mechanisms involved with cognitive decline in older age. To date, there has been a lack of research investigating this association, particularly among adults with mild cognitive impairment (MCI).

Methods and analysis: 15-25 cognitively healthy participants and 15-25 patients with MCI (age 40-85 years) will be recruited to participate in an exploratory study investigating the association between cognitive functioning and listening effort. Both behavioural and objective measures of listening effort will be investigated. The sentence-final word identification and recall (SWIR) test will be administered with single talker non-intelligible speech background noise while monitoring pupil dilation. Evaluation of cognitive function will be carried out in a clinical setting using a battery of neuropsychological tests. This study is considered exploratory and proof of concept, with information taken to help decide the validity of larger-scale trials.

Ethics and dissemination: Written approval exemption was obtained by the Scientific Ethics Committee in the central region of Denmark (De Videnskabsetiske Komiteer i Region Hovedstaden), reference 19042404, and the project is registered pre-results at clinicaltrials.gov, reference NCT04593290, Protocol ID 19042404. Study results will be disseminated in peer-reviewed journals and conferences.

Keywords: audiology; delirium & cognitive disorders; protocols & guidelines.

Conflict of interest statement

Competing interests: MB and FP are affiliated with Demant subsidiaries, of which Oticon provided audiometric testing equipment for the purposes of this study.

© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
SWIR Test procedure. For the purpose of this figure, sentence and final word examples are translated from Danish to English. SWIR, sentence-final word identification and recall. ISTS, International Speech Test Signal. SNR, signal-to-noise ratio.
Figure 2
Figure 2
HINT procedure. For the purpose of this figure, the sentence example has been translated from Danish to English. HINT, Hearing in Noise Test. SNR, signal-to-noise ratio.
Figure 3
Figure 3
Power estimate for listening effort. Percentage increase in peak pupil dilation between those with and without cognitive dysfunction.
Figure 4
Figure 4
Power for Symbol-Digit Modalities Test. Correlation needed to detect an effect of peak pupil diameter for moderating performance.
Figure 5
Figure 5
Power for Logical Memory Test. Correlation needed to detect an effect of peak pupil diameter for moderating performance.
Figure 6
Figure 6
Power for Stroop Test. Correlation needed to detect an effect of peak pupil diameter for moderating performance.

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