Hearing Loss and Neurocognitive Disorder After reading “Not Cured … But Improved” (June 2016), we wanted to thank Tammy Hopper for detailing the importance of appropriate treatment for persons with Alzheimer’s dementia and their families. However, we want to comment on two points. The first is that the “Diagnostic and Statistical Manual of Mental Disorders” ... Inbox
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Inbox  |   September 01, 2016
Hearing Loss and Neurocognitive Disorder
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Hearing Disorders / Inbox
Inbox   |   September 01, 2016
Hearing Loss and Neurocognitive Disorder
The ASHA Leader, September 2016, Vol. 21, 4. doi:10.1044/leader.IN2.21092016.4
The ASHA Leader, September 2016, Vol. 21, 4. doi:10.1044/leader.IN2.21092016.4
After reading “Not Cured … But Improved” (June 2016), we wanted to thank Tammy Hopper for detailing the importance of appropriate treatment for persons with Alzheimer’s dementia and their families. However, we want to comment on two points.
The first is that the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5) is now recommending the diagnostic term “neurocognitive disorder” (NCD) rather than dementia, although there is recognition that “dementia” will remain part of medical vernacular.
Second, hearing loss was not mentioned as a potential comorbid condition, despite its high prevalence in this population and recent concerns raised about causal or common-source relationships. Hearing loss can impact the diagnosis and treatment of NCD, but rarely is ruled out prior to NCD diagnosis—despite overlapping symptoms. The five domains affected by NCD and the procedures used for diagnosing NCD have notable auditory-verbal components. Consequently, hearing loss can compromise the results—potentially resulting in misdiagnosis or overestimation of severity. Hearing loss can increase the functional severity of NCD and make otherwise healthy patients appear positive for the disorder. So, too, audiologists should be vigilant to hearing loss masking the presence of NCD, and although it remains unclear whether the fitting of auditory sensory devices can prevent or slow the progression of NCD, the use of these technologies can improve patient interactions with family members and contact with the environment.
We recommend consideration of hearing loss when diagnosing and treating NCD, and encourage the treatment of co-occurring hearing loss to improve outcomes.
Lindsey E. Jorgensen, Vermillion, South Dakota, and Sheila R. Pratt, Pittsburgh

Thank you for clarifying the terminology and emphasizing the importance of evaluating and treating hearing loss in people with neurocognitive disorders.

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September 2016
Volume 21, Issue 9