Published in January 2022
"Face mask use in healthcare settings: effects on communication, cognition, listening effort and strategies for amelioration | Cognitive Research: Principles and Implications | Full Text" https://cognitiveresearchjournal.springeropen.com/articles/10.1186/s41235-021-00353-7
With the results stating,
"mask use significantly increased listening effort, with hearing loss having an additive effect on listening effort. Listening effort was also significantly associated with more trouble understanding conversation, decreased interest in conversation, more difficulty connecting with patients, changes in cognition for both providers and patients, and changes in the clinical efficiency of providers. Hearing loss had an additive effect for trouble understanding conversations and changes in clinical efficiency."
While the test focused on the requirement of visual acuity of seeing one's face and movement of the mouth to help understand speech there is another component that should be addressed.
Ears are attached to the sinuses via the Eustachian Tubes to equalize the pressure of the middle and inner ear. stagnant air trapped by the masks builds up in the Eustachian Tubes which can cause sinus infections and other forms of tube blockage that can affect hearing acuity.
Cogscreen has several components that require the discernment of tones of different frequency, including identifying sequences of similar and dissimilar tones not unlike a game of "Simon." Another test involves tone changes to identify a change in variables of identifying geometry which is similar to the "Wisconsin Card Sorting Test"
It is not unreasonable to assume that these loss of hearing acuity makes it more difficult to discern the tones in the Cogscreen. As previously discussed even slight delays in answering questions in the Cogscreen can greatly weaken the score of the test taker leading to a false positive of being "cognitively slow" and "defective" This type of discriminatory profiling is not unlike racism.