Why do you screen cognition for a hearing test?

At Alabama Hearing Associates, we don’t just treat your ears; we treat the whole person.

While your ears collect sound, your brain is what interprets it into meaningful speech.

In other words, you hear with your ears but you listen with your brain. 

There is increasing evidence that links age-related hearing loss with an accelerated progression of cognitive decline and a decrease in brain volume.

Long-term hearing deprivation can affect cognitive performance by decreasing the quality of communication with others.

That’s why we use Cognivue® as an integral part of our “Connect 365” Functional Hearing Assessment.

How do I complete the Cognivue® Thrive?

Cognivue is a 10-minute screener that is completed using a laptop.

One of our staff will set you up in a dimly lit room with no distraction to ensure the best score possible.

You’ll first start with this quick introductory video: 


After the video, you’ll go through five different exercises.

The exercise becomes more difficult the better you do.

At the end, your results are compiled and compared to other people your gender and your age.

The audiologist will go over the results at the end of the appointment. 

One thing I love about Cognivue® is that hearing ability isn’t a factor in the process. Even the short introductory video includes captions for those with more severe hearing loss.

This feature is very uncommon as most cognitive screeners only use auditory instructions and questions. 

What does the Cognivue® evaluate?

Cognivue® evaluates three cognitive domains (memory, visuospatial, and executive function) and two parameters (processing speed and reaction time) that heavily influence hearing in everyday listening environments. 

For more specifics on the Cognivue® domains and parameters, read below:

Memory: As hearing loss becomes more severe, your risk of not storing information properly increases, making it more difficult to retrieve information. On the other side of this, someone’s ability to remember decreases if trying to remember a degraded signal (such as what happens when someone hears through a hearing loss).

Visuospatial: Visuospatial capabilities are important for localization, whether it’s a dog barking or if you’re moving around a room. A decrease in visuospatial functioning in addition to untreated hearing loss increases your risk of falling—BUT the research shows us that correcting your hearing loss reduces your risk of falling.

Executive Function: Executive Function impacts your ability to hear in noisy environments. People with impairment in executive function tend to have more difficulty in situations with multiple speakers than in environments with non-speech noise (such as wind or road noise).

Processing Speed: Processing Speed impacts your ability to efficiently use your executive functioning. For people with an impairment with processing speed it may take a bit longer to process conversational speech in noise and someone may be more likely to stop paying attention if the listening environment is very difficult.

Reaction Time: Reaction Time impacts your ability to follow rapid conversation and follow multiple talkers, as well as your ability to respond quickly to questions and comments.

If you would like to schedule an appointment for a Cognivue® screening, please call us at 256-319-4327 or submit a contact request and one of our helpful team members will call you back shortly.

Do you know somebody that needs to see this? Why not share it?

Dr. Jan Liles

Dr. Liles earned her bachelor’s degree from the University of Montevallo and her master’s degree from the University of Alabama. From 1991 to 2001, she worked with two ENT medical practices and initiated one of the first newborn hearing screening programs in the state. In 2002, she was awarded a doctorate in audiology from the University of Florida. Dr. Liles and her longtime best friend, Dr. Sheehy, founded Alabama Hearing Associates in January 2002.
    Basic Hearing Test

    A basic hearing test begins with an air conduction test. You will be seated in a soundproof booth and single-use, foam earphones will be inserted into your ear canals. The Audiologist will ask you to push a button or raise your hand when you barely hear a series of beeps (tones) presented at various frequencies (pitches) to obtain your air conduction thresholds.

    To determine whether your hearing loss is a conductive (mechanical) loss, sensorineural (permanent) loss or combination of the two, we perform a bone conduction test.  

    For this test, a head band is place on the bone behind one of the ears to obtain your bone conduction thresholds. This process provides a different form of sound transmission using vibration, which bypasses the eardrum and the middle ear bones and directly stimulates the auditory nerve. When you hear the beeps/tones, you will push a button or raise your hand.

    If bone conduction thresholds are better than air conduction thresholds (through the foam inserts), you have a conductive hearing loss. This suggests a problem with the mechanical structures (moving parts) of the ears.

    Conductive hearing loss is often a medically treatable condition for which we will provide you with a referral to an Ear, Nose and Throat (ENT) physician. However, if bone and air conduction thresholds match, it indicates a sensorineural hearing loss (permanent), and the treatment will likely involve hearing aids.



    Comprehensive 5-Year treatment plan with premium technology

    If you want premium “out of this world” technology and the highest level of service and expert support, our All-Inclusive treatment plan is the right investment for you.

    The All-Inclusive treatment plan offers long-term value for your on-the-go lifestyle, providing everything you need to connect with family and friends for years to come.


    • Stellar hearing devices from top manufacturer (rechargeable option available)

    • Wireless accessory included at no charge

    • Comprehensive Annual Visit including hearing assessment, hearing device adjustment, and 19-Point preventative maintenance valutaion

    • Bi-annual hearing aid software update and reprogramming

    • Same day diagnosis and in-office repair during weekdays for devices dropped off before 3:00 p.m.

    • 5-Year full-service repair warranty

    • Unlimited remote hearing aid adjustments

    • 100% moisture removal by Redux and cleaning

    • Hearing aid supplies (stock receivers, batteries, domes and filters)

    • $1000 contribution towards purchase of upgraded technology within 48 months

    • 3-Year replacement warranty for loss or damage (no deductible)

    • Dedicated team of hearing care experts at your service

    • Unlimited teleaudiology appointments

    • Access to our “speed of light” repair specialists