We acknowledge and appreciate Dr Rosch's interest in our study. We fully agree that hearing loss is important to detect and correct, if possible. The original comprehensive functional assessment of our elderly patients did include a notation whether the patient could hear the investigator's normal speaking voice. Because we did not make an objective measurement of hearing loss, we felt that it could not be included in the final reporting of our data.
Dr Rosch does not comment on which bedside instrument he would use for hearing loss. We would recommend a pure tone audiometric screening at 30dB hearing threshold level at frequencies of 1.5 kHz and 2 kHz for each ear. Failure to pass criterion would justify referral for audiologic follow-up. The choice of test frequencies is justified because compromise of acuity of these two key speech frequencies, either singly or in combination, would affect speech recognition significantly.