Access Type

Open Access Dissertation

Date of Award

January 2017

Degree Type


Degree Name




First Advisor

Lisa J. Rapport


Prior research has found that adults with hearing loss perform worse on cognitive testing than adults without hearing loss, and some studies have suggested that hearing loss is associated with dementia. Heavy emphasis on tests involving auditory stimuli for memory assessment may result in overdiagnosis of cognitive impairment in individuals with hearing loss. The present study compared visual and auditory versions of a verbal memory test among older adults with and without hearing loss. Forty-one adults with moderate-to-severe, sensorineural hearing loss (HL) and 41 age-matched adults with normal hearing (NH) participated. Age ranged from 55 – 80 years. They completed a neuropsychological battery that included auditory and visual versions of the Hopkins Verbal Learning Testing-Revised (HVLT-R). The auditory conditions included a Natural Auditory condition for which stimuli was presented at a normal speaking volume and a Crossed Auditory condition for which individuals with hearing loss completed the test with amplified volume and individuals with normal hearing completed the test under a hearing loss simulation. Mixed-model ANOVA indicated significant group (HL vs. NH) by condition (Visual vs. Natural Auditory vs. Crossed Auditory HVLT-R) interactions with large effect sizes. Post hoc contrasts showed that the HL group performed significantly worse than the NH group on the Natural Auditory version. The opposite pattern was found for the Crossed Auditory condition: The NH group performed significantly worse than the HL group. The groups were equivalent on the Visual condition and showed small effect sizes. Auditory and visual versions were highly correlated for the NH group but not for the HL group. Groups did not significantly differ on other neuropsychological tests and showed small effect sizes. Moreover, for the HL group, the visual version of the verbal memory test was strongly correlated with other neuropsychological tests whereas the standard auditory version was not. Cognitively intact older adults with hearing loss appeared impaired on an auditory-verbal word list memory test under typical administration conditions. Visual assessment of verbal memory shows evidence of superior validity and is a viable alternative method to assess memory function especially in older populations.