Integrated digit in noise test (iDIN) for rapid hearing and cognitive screening: a preliminary exploration

Background Hearing and cognitive impairments are common amongst older adults, both affecting communication and are not easy to distinguish from each other.Objective To preliminarily evaluate the efficacy of the integrated Digit in Noise Test (iDIN) for rapid screening of hearing and cognitive functions in older adults.Design This cross-sectional cohort study was conducted at multiple clinical sites.Setting Data collection occurred in sound-treated booths and quiet rooms at several outpatient clinics and elderly community centres.Subjects The study included 107 older adults, aged 58-96, who were long-term residents of Hong Kong and native Cantonese speakers. Participants were selected through convenience sampling.Methods Primary outcomes were the speech reception thresholds (SRTs) for 2-, 3- and 5-digit sequences with forward and 3-digit sequences with backward recall measured on iDIN. Hearing level was assessed using pure-tone audiometry. Cognitive function was assessed using the Hong Kong version of the Montreal Cognitive Assessment (HK-MoCA).Results The 2-digit and 3-digit SRTs effectively distinguished participants with hearing loss, demonstrating high sensitivity (0.815 and 0.908, respectively) and specificity (0.905 and 0.853, respectively). The SRT3b-3f index effectively discriminated between participants who passed or failed the MoCA, with sensitivities of 0.727 and 0.781, and specificities of 0.885 and 0.787 using the two MoCA scoring methods. No significant correlation was found between SRT3b-3f and hearing levels after adjustment for educational background.Conclusions iDIN demonstrates significant promise for rapid and effective screening of both hearing and cognitive impairments in older adults.