We investigated the effect of background noise on performance on the Montreal Cognitive Assessment (MoCA). Two groups of older adults (one with clinically normal hearing, one with hearing loss) and a younger adult group with clinically normal hearing were administered two versions of the MoCA under headphones in low and high levels of background noise. Intensity levels used to present the test were customized based on the hearing abilities of participants with hearing loss to yield a uniform level of difficulty across listeners in the high-level noise condition. Both older groups had poorer MoCA scores in noise than the younger group. Importantly, all participants had poorer MoCA scores in the high-noise (M = 22.7/30) compared to the low-noise condition (M = 25.7/30, p < .001). Results suggest that background noise in the test environment should be considered when cognitive tests are conducted and results interpreted, especially when testing older adults.
