Coupling Hearing Health With Community-Based Group Therapy for Cognitive Health in Low-Income African American Elders

Abstract

Purpose: To address disparities in the domains of hearing health and cognitive health experienced by African American elders in early stages of cognitive-communicative decline, a cognitive stimulation therapy (CST) group was established. The group intervention was coupled with comprehensive audiology services. This clinical focus article describes the features of the program, its implementation, and outcomes from its first cohort of participants. Method: CST is an evidence-based group intervention for elderly individuals living with mild-to-moderate dementia. The program was designed to (a) adapt and then apply CST to a target group of low-income African American elders and (b) integrate audiology services and education about hearing health and hearing loss in the context of CST therapy. In partnership with two community health centers in North St. Louis, a CST group was established for 12 elderly African American clients with cognitive-communicative impairments as measured by standardized assessments. During weekly group sessions, culturally informed activities and discussions were conducted with input from staff and participants to stimulate social interaction and cognition. Health topics relevant to age-related sensory and cognitive decline were introduced, with emphasis on management of common chronic diseases such as diabetes that are known to be associated with increased risk of hearing loss. Free hearing health services were provided, including screenings and, as needed, full audiological evaluations, cerumen management, otolaryngology referrals, hearing aids, and aural rehabilitation. Results: Participants' self-administered ratings and self-generated comments indicated meaningful increases in actionable knowledge about both hearing and cognitive health that led to enhanced utilization of available health services. They also suggested that audiology services were paramount to their enthusiastic adherence to the combined CST–audiology program. Conclusion: Interlinking of interventions for hearing and cognition reduced common barriers to care for this target group of low-income African American elders with cognitive-communicative impairments.