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#20 - The connection between impairment and cognitive performance

More and more research points to a direct connection between hearing impairment and cognitive performance. Today we talk with David TenBarge with Cognivue to find out why on Ask The Hearing Doctors...

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Transcript:

The connection between hearing impairment and cognitive performance. Today, we talk with David TenBarge with Cognivue on Ask The Hearing Doctors.

 

[inaudible]

 

Hi, I'm Jim Cuddy. And this is Ask The Hearing Doctors and I'm joined today by Dr. Ana Anzola, Doctor of audiology with Hearing Doctors. The Washington, DC area's highest-rated audiology practice with over 1,500 five-star reviews. Also joining us today, David TenBarge, Senior Vice President of Marketing and Channel Development with Cognivue, hello to you both. David let's start with kind of an overview of Cognivue. Sure.

 

Cognivue is, uh, a cognitive screening, uh, manufacturer of devices that is based on, uh, NIH technology was funded from the NIH for about 15 years. And the company's been around for about that amount of time, but it's now just in the last couple of years, the product is being, uh, well-received in the healthcare community.

 

There, of course, has been a pretty good amount of research on the topic of hearing and hearing impairment and cognitive function and performance lately. And we've even talked a little bit about it here. Can you provide us, a simple explanation to that connection and why it's important for, for people to understand? Sure.

 

Well, there's been a lot of, a lot of research and publications in the last several years about the connection and correlation between hearing impairment and cognitive performance. Uh, everything is kind of culminating together now where there's technology through Cognivue that allows for a new healthcare provider class of screeners, right? Cognivue is a screening device and not intended to be a diagnostic tool. That's where your MDs and neurologists come into play, but we're providing wider access. So the information now with the correlation between hearing impairment and other contributing factors, uh, to cognitive decline, we're now able to catch it earlier. So it's an important time, uh, in healthcare for hearing and cognitive decline.

 

I mean, in essence, is it a starting point for, for recognizing a potential problem?

 

Yes, absolutely. So, uh, prior to Cognivue, it was really a very, people are very familiar with the manual test, the pen, the paper and the pencil tests. Uh, that was cumbersome, difficult to, to implement in a, uh, in a busy practice, like Hearing Doctors. Uh, now Cognivue has automated that process. So it really kind of opens up the market for, uh, hearing, uh, health providers to provide screening for the first time. So a new class of screening population that can help, uh, patients really identify mild cognitive decline in the early stages.

 

Ana, how, how does a Cognivue screening work in the bigger picture of things of your assessment of somebody's impairment or their situation?

 

Great question. So when we conduct a hearing test, we incorporate things like speech understanding and not just speech understanding in quiet, but we actually do it in noise as well. So giving us better information and how to apply the best recommendations with the patient. But now we actually can measure their cognitive performance and then tie it all together. So, you know, in my experience, I've had patients that have performed really poorly in their, um, speech recognition scores in noise, and have also shown that in their Cognivue, when we do the cognitive screening, um, it shows that they're more impaired that the cognitive scores are not where they should be, but there's more of a correlation. And there are going to be a lot more studies about this, but this is just in our experience here at Hearing Doctors. And so when we recommend, um, what type of hearing technology would actually give them the best optimal hearing, we know and we can measure that. And we've been able to do that with our patients, that they perform better with more premium technology, because it, it really gives them the more optimal performance. It has better algorithms within the, um, the model and the technology to really give them the best outcomes.

 

Now, you are familiar with the larger cognitive health system. Right. What role does the audiologist have in promoting cognitive health with their patients?

 

That's a, that's a great question. And it's one that we're excited about. It's, we're excited to have the audiologist and hearing health professional, be part of an ecosystem of cognitive health. If you think about it Jim, uh, every, uh, you know, cardiovascular started, you know, 50 years ago. There wasn't a lot known about it and it progressed and patient protocols were established. Now by and large, most people know what they should be doing about cognitive, about, uh, cardiovascular health, where they should go, what, what the remedies are, the prescriptions, the health lifestyle, uh, programs should be taking. Cognitive health is now getting into that same mode. You know, we're living longer. Uh, we're learning more about cognition and the, the hearing health professional is really now, uh, providing more earlier access and understanding. And they're the beginning, if you will, of that food chain bringing patients through the ecosystem of cognitive health.

 

Now, how does the introduction of the audiologist in the cognitive health ecosystem, as you say, how does that help improve patient care?

 

Well, you know, if you look at statistics, most people will go to an optometrist or a hearing health professional, an audiologist, much more frequently than they would a primary care physician only because these are prominent topics of mind, it's it's day to day impact to them. Uh, so what it does is creates access. Primary care physicians generally, uh, they're a very important, uh, element to that model, but they've, an average primary care physician has 2,500 patients. So, uh, this provides a partner, the screen they're kind of the tip of the spear now. The, the hearing health professional, uh, and a partner to catching, uh, mild cognitive decline early, and then working with the MD, whether the primary care physician or the neurologist to transition that patient, if, uh, their situation is where it warrants it. Many cases you could, uh, really cap capture and identify cognitive decline early, mild cognitive decline, and address it through things like hearing correction.

 

This seems so obvious to me now talking about it, but why has this taken so long to get to this point?

 

Uh, really some of the reasons that were cited earlier. I think the technology, the inability to integrate it into, uh, environments like Hearing Doctors. Cognivue is a very sensitive, has a very sensitive and, um, reliable test mandate. So it can pick up mild cognitive decline early and before that the technology didn't exist. So a lot of people would wait until there was a real cognitive problem and they were seeing a neurologist.

 

What should a patient expect in a Cognivue screening? Right. So this is, you know

 

it's a great question because a lot of people have this sense of fear that a audiologist or hearing health professional is going to diagnose you with Alzheimer's or dementia. Um, that's not the case. This is not a diagnostic tool at all. What it is really doing is, is measuring the, uh, cognitive load that you may be experiencing through, uh, increased listening effort, which is a result of impaired hearing. Um, as your hearing, uh, is, you know, diminishes perhaps over time or through natural reasons, your brain literally has to work harder. So, uh, what a patient should expect is a very simple, painless process. It takes about five to eight minutes for this, for the screening. We don't even call it a test by the way, there's a, a device that you turn around a wheel, no keyboards, uh, there's no audio, uh, stimuli there. You're just reading instructions and following a pattern. And then the results of that, uh, that screening are, made almost immediately available to the patient and your, and the servicing audiologist.

 

Are there common misperceptions?

 

Yes. I think, I think the, the, again, the fear that it's a diagnostic tool for Alzheimer's and dementia is not, or it's a IQ test. Um, you know, there's such a, uh, opportunity to educate more with the patients now. It's an exciting time because patients would really actually be actively looking to do this because the first stop in, uh, really addressing any kind of mild cognitive decline is through correction of hearing impairment, because it has been identified in recent research as the most modifiable, uh, contributor to cognitive decline and the biggest contributor to cognitive decline. So, you know, it's always exciting when you actually can now read something earlier and do something about it, and that's, what's exciting about it.

 

So, Ana, do you run into this where people are, they're scared? Oh my gosh, I don't want to take this. What am I going to find out about me? Yeah.

 

So again, I think like we were talking about earlier, it's all about presentation, making sure that you present it in a way that it's not scary, that you're not adding to the anxiety of taking another test. I mean, I just went through a hearing test now I have to put them through another test. So, and you want to explain the benefits. It's not a diagnostic tool, it's a screening tool. And we're not going to scare you, it's very simple. We show them, um, and we go, we go through the different steps, identifying, you know, what should you expect to get out of this screening tool and then asking permission to see if we can, you know, communicate this to whether it's a family member or their primary care physician or their neurologist. But to us its more having more conversation about the cognitive side of things, not just the hearing and audition, but just the cognitive, learning more and identifying it early.

 

Oh, absolutely. That's key. And I guess this question is kind of to both of you. So when a patient takes that cognitive screening, are there, are there benchmarks that, that, the system has set up with that that would tell the audiologist, Hey, here's, here's a little red flag. Maybe we need to work with the primary care.

 

Yeah, sure. I, um, yes. Uh, the reports generated, as I mentioned earlier, almost immediately, and the audiologist will use that information, uh, to make, uh, it'll contribute to a larger assessment of the, of the hearing needs and correction. And if there is a, a hearing correction need, um, a lot often where the Cognivue is going to pick up, uh, some, some areas, what we call brain domain functions that are, um, maybe not as high in performance as they should be. For example, executive function, executive function is, is really the ability to stay focused. Um, we'll often see people with impaired hearing that's been not treated, uh, where they're, they have less than desirable, um, ratings on that. It's a very simple, uh, report that shows you exactly where you fall on that line. And again, the audiologist takes that information, not as a single point of reference, but as a total comprehensive view of what they should be doing to help that particular patient. And you can benchmark that. So, often I'm sure Ana does this as well is they come back three to six months. They have their, they know what their benchmark is. They've corrected their hearing. There's actually, um, some, uh, rehab, cognitive rehab, uh, tools and resources available as well, come back six months and they measure them again.

 

Do they, do they potentially improve their cognitive abilities by correcting their hearing impairment?

 

Well, you know, it's a great question, Jim. There's actually a very large study underway with Johns Hopkins. That's the, it's the, the million dollar question now is, Can you arrest and then potentially reverse cognitive decline? Uh, the, the study is called ACHIEVE. I think the output will be sometime next year. I could, I can tell you that, uh, from observations, uh, they, uh, audiologists have told me, uh, because they can now measure it that once they correct hearing in particular situations, there is an improvement in the mild cognitive decline. And remember we're, we're separating, you know, significant problems where they have to see a physician or neurologist. We're talking about the impact of hearing on your brain when the hearing impairment is treated, uh, there is definitely positive impacts to the mild cognitive decline that's being measured. And the [inaudible]. So that'll be formalized in bigger studies.

 

It's absolutely a fascinating topic and, and it's wonderful that the technology is there and it's growing to hopefully improve people's lifestyles everywhere. Uh, Ana, David, thank you both for joining us today and enlightening us to Cognivue. Thank you. Thank you. If you're in the Washington metropolitan area and you'd like to schedule an appointment with Hearing Doctors, click the link in the description or visit hearing doctors.com

 

[inaudible].

 


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