Is cortical automatic threshold estimation a feasible alternative for hearing threshold estimation with adults with dementia living in aged care?

Objective: This study explored the feasibility of cortical automatic threshold estimation (CATE), a fully automated late auditory evoked potential (AEP) test, as an alternative to pure-tone audiometry for hearing threshold estimation for adults with dementia living in aged care.Design: A single group cross-sectional study was conducted. Participants' dementia severity was determined through the Clinical Dementia Rating scale. Hearing thresholds were obtained for four audiometric frequencies in at least one ear by using both pure-tone audiometry and CATE.Study sample: Sixteen participants enrolled in the study, of which 14 completed at least one of the hearing tests. Twelve ears, from six participants, were included in the final correlation analysis.Results: Pearson correlation coefficients were significant between CATE and pure-tone audiometry for all frequencies: r2 = 0.52 (p = 0.008) for 500 Hz, r2 = 0.79 (p = 0.0001) for 1000 Hz, r2 = 0.71 (p = 0.0005) for 2000 Hz, and r2 = 0.92 (p < 0.0001) for 4000 Hz. Cortical thresholds were within 10 dB of behavioural thresholds for all four frequencies.Conclusions: Findings are encouraging for the feasibility of CATE as an alternative diagnostic test to pure-tone audiometry for adults living with dementia in aged care.