Clinicians should consider screening for sensory impairments prior to initiating a brain health–focused conversation or as part of screening and assessments for changes in cognition. Individuals, especially older adults, may have sensory loss such as hearing or vision loss that can interfere with effective communication in primary care visits. If undetected, these impairments may be mistaken for cognitive impairment. Additionally, individuals with dual sensory loss are at increased risk for dementia (Hwang, 2020). However, treatment for hearing loss in individuals at high risk for cognitive decline has been shown to reduce cognitive changes over 3 years (Lin, 2023). The GSA podcast ACHIEVE: A Landmark Study of the Effect of Hearing Intervention on Brain Health in Older Adults provides more information about these findings.
The Hearing Handicap Inventory for the Elderly is a widely recommended brief screening test for hearing loss. Additionally, the Hearing Number is a new metric that can be used by individuals that assess whether they have hearing loss. Individuals can use a smartphone app to measure their hearing number. More details as well as other options for assessing this metric are available at What Is the Hearing Number?
To assess for vision loss, consider asking a single question from the American Community Survey: “Are you blind or do you have serious difficulty seeing even when wearing glasses?” (U.S. Census Bureau, 2017).
If hearing or vision loss is detected, the Addressing Sensory Loss Checklist can provide strategies to help with effective communication.
The one-page summary of tips based on GSA’s Communicating With Older Adults: An Evidence‐Based Review of What Really Works , is also a helpful resource.
Overview | Discuss Brain Health | Engage in Conversations About Protective Actions | Address Diverse Life Experiences | Discuss Memory and Cognition | Observe for Signs and Symptoms of Cognitive Impairment | Listen for Patient and Family Concerns About Cognition | Address Any Sensory Loss and Use Effective Communication Strategies | Use Health Questionnaires | Use Electronic Health Records | Primary Prevention Recommendations for Reducing Risk of Cognitive Decline | Warning Signs That Might Indicate Dementia | Resources for Patients About Brain Health | Kickstart References