PP902 - ENT Physicians’ and Audiologists’ Approaches to Hearing Loss and Cognitive Impairment: a KAP study

Abstract: This study examined the knowledge, attitudes, and practices of Brazilian audiologists and ENT physicians regarding hearing loss and cognitive impairment. Eighty-eight professionals (77 audiologists; 11 ENTs) completed an online survey using the Portuguese KAP 2.0 questionnaire. Respondents reported good knowledge and positive attitudes toward identifying and discussing cognitive concerns; however, these did not translate into consistent clinical practices. Limited training and workplace support likely contributed to these gaps. Strengthening practice will require clearer guidelines, targeted training, and organizational support to improve screening and referral pathways.

Summary: Rationale: The growing prevalence of age-related hearing loss and dementia poses a major public health challenge. As untreated hearing loss is a modifiable risk factor for cognitive decline, this places hearing-care professionals in a strategic position to identify early cognitive changes, initiate timely referrals, and support patients and families. Yet, their preparedness to recognize, discuss, and act on cognitive concerns remains unclear.

Purpose: To assess the knowledge, attitudes, and practices (KAP) of Brazilian audiologists and ENT physicians regarding management of patients with suspected or confirmed hearing loss and cognitive impairment/dementia.

Methods: Preliminary report of a cross-sectional online survey. Recruitment occurred via social media, email, and snowball sampling (Ethical approval Protocol nº 6.576.747). The Portuguese version of the KAP 2.0 questionnaire (Jayakody et al., 2024) was administered, comprising 41 items covering demographics, KAP (awareness, perceptions, and clinical behaviors related to cognition) and training preferences. Most items used 5-point Likert scales (e.g., strongly disagree–strongly agree; never–very frequently). Although the percentage of each response option was calculated for every item, only the most positive categories are reported here—that is, agree or strongly agree for agreement items, and frequently or very frequently for practice-frequency items.

Results: A total of 88 professionals completed the survey (77 audiologists; 11 ENTs). Most were female (84.1%), aged 35–54 years (59%), had over 10 years of experience (65.9%), and practiced mainly in clinics (75%) and in the private sector (48.9%). In the knowledge domain, respondents reported awareness of the association between hearing loss and cognitive decline; however, deficits were observed in procedural and applied knowledge, particularly regarding cognitive screening and integrating cognitive-support strategies into rehabilitation. In the attitudes domain, respondents expressed positive views toward integrating cognition into hearing care. Most endorsed the importance of asking about memory concerns, acknowledged their role in identifying cognitive impairment, and agreed that hearing-care professionals should screen and refer patients when needed. In contrast, practice behaviors were less consistent. Only a few actions, such as discussing the hearing–cognition relationship or engaging caregivers, were reported by ≥70% of respondents. Most behaviors, including structured questioning, written instructions, and referral processes, fell below this threshold. Formal cognitive screening was rare (18.2%). Limited access to resources, training, and workplace support likely contributed to these results. Training exposure was low: only 12.5% had received prior instruction related to cognition, all through online workshops. Preferred training formats included self-paced online courses and in-person workshops. Desired content emphasized clinical guidelines for evaluating and rehabilitating patients with hearing loss and cognitive impairment.

Conclusion: Brazilian audiologists and ENT physicians reported good knowledge related to hearing loss and cognitive decline/dementia and expressed favorable attitudes, but these did not translate into consistent clinical practices. Strengthening clinical practice will require structured formal education, clear guidelines, and targeted training, as well as organizational support to enable more effective screening, management, and referral pathways.