The Impact of Audibility and Voice on Young Adult Performance on the Mini-Mental State Examination

Abstract

Purpose: The purpose of this study was to assess the impact of reduced audibility (RA) and speaker voice on performance on the Mini-Mental State Examination (MMSE) in individuals with normal hearing. Method: Participants with normal hearing (n = 31) were randomly assigned to complete the MMSE with normal audibility or with RA. Instructions for the MMSE were recorded by both a male and female speaker and normalized via Audacity software. Voice of speaker was randomized for each participant. Scores on the MMSE were measured for each condition and compared using an analysis of variance between the two groups. Results: This study found that the RA group performed significantly worse on the MMSE compared to those with no reduction in audibility. There was no difference in performance in either group when accounting for instructor's voice. Audiometric results, such as pure-tone averages and Quick Speech in Noise scores, significantly correlated with MMSE performance. Conclusion: Individuals with RA performed significantly worse on the MMSE than those with normal audibility, regardless of the voice of instruction. These findings suggest that health care providers, regardless of vocal characteristics, should be cognizant of potential hearing loss prior to assessing patients for cognitive impairment.