Severe and profound hearing loss in patients with multiple sensory impairments: increased incidence of cognitive impairment

• Combined sensory dysfunction increased the odds of cognitive impairment. • More severe hearing loss increased the likelihood of cognitive impairment. • Patients with hearing loss should be screened for other sensory disorders. Determine odds of incident cognitive impairment among patients with severe to profound hearing loss and co-existing multisensory impairment. 14 prospectively recruited aging (age 50+) patients with severe and profound hearing loss were pooled for analysis with 180 previously enrolled patients with demonstrated multisensory impairment. Patients were recruited as part of a cross-sectional case-control study at a tertiary care neurotologic/audiologic outpatient clinic. Patients with severe and profound hearing loss were identified and underwent point-of-care multisensory testing and cognitive testing. Multisensory testing using the Affordable, Rapid Olfactory Measurement Array (AROMA) for olfaction, pure tone audiometric evaluations, and the Timed ‘Up and Go’ test for gait and balance. Cognitive impairment was assessed via the Montreal Cognitive Assessment for the Hearing Impaired (HI-MoCA). A total of 194 patients were included. 34% (n = 66) screened positive for cognitive impairment. Olfactory dysfunction, gait impairment, and sensorineural hearing loss were all significantly (p < 0.05) associated with higher odds of cognitive impairment (ORs = 3.17, 3.71, and 3.23, respectively in a multivariate model). Subjects with dysfunction in all domains were at highest risk for cognitive impairment (OR = 15.2, p < 0.001) compared to impairment in 2 domains (OR = 5.09, p < 0.001). Severe and profound hearing loss had higher odds (OR = 8.32) compared to mild-moderately severe hearing loss (OR = 2.81) of having incident cognitive impairment. Dysfunction of the olfactory, auditory, and balance systems is associated with significantly increased odds of cognitive impairment. Patients with severe and profound hearing loss were more likely to have cognitive impairment.