Neurocognitive testing and cochlear implantation: insights into performance in older adults

• Published in: Clinical interventions in aging Vol. 11; pp. 603 - 613
• Main Authors: Cosetti, Maura K, Pinkston, James B, Flores, Jose M, Friedmann, David R, Jones, Callie B, Roland, Jr, J Thomas, Waltzman, Susan B
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2016; Taylor & Francis Ltd; Dove Medical Press
• Subjects: Age; Aged; Aged, 80 and over; ageing; Aging; Alzheimer's disease; Cochlear Implantation; Cochlear Implants; Cognition; Cognition & reasoning; Cognition Disorders - epidemiology; Cognitive ability; cognitive function; cognitive impairment; Comorbidity; Deaf women; Dementia; Elderly patients; Evaluation; Female; Hearing aids; Hearing loss; Hearing Loss - psychology; Hearing Loss - therapy; Hearing Tests; Humans; Logistic Models; Medical examination; Neuropsychological Tests; Neurosurgery; Old age cognition; Older people; Original Research; Otolaryngology; Patients; Prospective Studies; Psychiatric Status Rating Scales; Psychological aspects; Quality of life; Speech Perception; Systematic review; Transplants & implants; United States; Womens health; United States; New York; United States > US; cognitive function; neuropsychological testing; cochlear implant; dementia; cognitive impairment; aging; hearing loss
• ISSN: 1178-1998; 1176-9092; 1178-1998
• DOI: 10.2147/CIA.S100255

The aim of this case series was to assess the impact of auditory rehabilitation with cochlear implantation on the cognitive function of elderly patients over time. This is a longitudinal case series of prospective data assessing neurocognitive function and speech perception in an elderly cohort pre- and post-implantation. University cochlear implant center. The patients were post-lingually deafened elderly female (mean, 73.6 years; SD, 5.82; range, 67-81 years) cochlear implant recipients (n=7). A neurocognitive battery of 20 tests assessing intellectual function, learning, short- and long-term memory, verbal fluency, attention, mental flexibility, and processing speed was performed prior to and 2-4.1 years (mean, 3.7) after cochlear implant (CI). Speech perception testing using Consonant-Nucleus-Consonant words was performed prior to implantation and at regular intervals postoperatively. Individual and aggregate differences in cognitive function pre- and post-CI were estimated. Logistic regression with cluster adjustment was used to estimate the association (%improvement or %decline) between speech understanding and years from implantation at 1 year, 2 years, and 3 years post-CI. Improvements after CI were observed in 14 (70%) of all subtests administered. Declines occurred in five (25%) subtests. In 55 individual tests (43%), post-CI performance improved compared to a patient's own performance before implantation. Of these, nine (45%) showed moderate or pronounced improvement. Overall, improvements were largest in the verbal and memory domains. Logistic regression demonstrated a significant relationship between speech perception and cognitive function over time. Five neurocognitive tests were predictive of improved speech perception following implantation. Comprehensive neurocognitive testing of elderly women demonstrated areas of improvement in cognitive function and auditory perception following cochlear implantation. Multiple neurocognitive tests were strongly associated with current speech perception measures. While these data shed light on the complex relationship between hearing and cognition by showing that CI may slow the expected age-related cognitive decline, further research is needed to examine the impact of hearing rehabilitation on cognitive decline.