Can cochlear implantation improve neurocognition in the aging population?

Abstract

IntroductionThe relationship between cognition and the ability to hear is well known. Due to changes in demographics, the number of people with sensorineural hearing loss and cognitive impairment is increasing. The aim of this study was to identify the impact of hearing rehabilitation via cochlear implantation on cognitive decline among the aging population.Patients and methodsThis prospective study included 60 subjects aged between 50 and 84 years (mean 65.8 years, SD=8.9) with a severe to profound bilateral hearing impairment. A computer-based evaluation of short- and long-term memory, processing speed, attention, working memory and inhibition was performed prior to surgery as well as 6 and 12 months after cochlear implantation. Additionally, speech perception at 65 and 80 dB (Freiburger monosyllabic speech test) as well as disease-related (Nijmegen Cochlear Implant Questionnaire) and general (WHOQOL-OLD) quality of life were assessed.ResultsSix months postimplantation, speech perception, quality of life and also neurocognitive abilities significantly increased. The most remarkable improvement after 6 months was detected in executive functions such as attention (p<0.001), inhibition (p=0.025) and working memory (n-back: p=0.002; operation span task: p=0.008), followed by delayed recall (p=0.03). In contrast, long-term memory showed a significant change of performance only after 12 months (p=0.021). After 6 months, most cognitive domains remained stable, except working memory assessed by the operation span task, which significantly improved between 6 and 12 months (p<0.001). No correlation was found between cognitive results and duration of deafness, speech perception or quality of life.ConclusionCochlear implantation does not only lead to better speech perception and quality of life, but has also been shown to improve cognitive skills in hearing impaired adults aged 50 years or more. These effects seem to be independent of each other.

<p>Benefits of Cochlear Implantation in Middle-Aged and Older Adults</p>

“…38 Besides, working memory improves post-implantation as shown in a recent study by our group in 20 elderly 12 months after implantation . 36 Similar findings have also been described by Jayakody in 16 CI recipients with a mean age of 61.7 that underwent testing with the Cambridge Neuropsychological Test Automated Battery (CANTAB). 35 …”

“…A visually based neurocognitive assessment tool (ALAcog), which is based on standardized paper and pencil versions adapted for hearing-impaired and already used in former studies, has been applied pre- and post-operatively. 46 , 47 The test battery is composed of 11 subtests, covering various cognitive subdomains as previously described in detail: 36 , 47 …”

Auswirkungen der SARS-CoV-2-Pandemie auf die universitäre Hals-Nasen-Ohrenheilkunde im Bereich der Krankenversorgung

“…Dieses Ergebnis ist bedenklich, da es sich in der Diagnostik und Therapie von Hörstörungen bei Kindern auch um das Neugeborenen-Hörscreening und die Cochlea-Implantat(CI)-Versorgung handelt, die beide als zeitkritisch zu betrachten sind und Verzögerungen zu erheblichen Beeinträchtigungen der gesamten Hör-/Sprachentwicklung und zu irreversiblen Entwicklungsschäden führen können [17]. Für Erwachsene steht durch eine Verzögerung der Diagnostik und Therapie von Hörstörungen die ausbleibende Verbesserung der Kommunikations-und Lebensqualität und der fehlenden Stimulierung kognitiver Prozesse im Vordergrund [18].…”

Die Sensitivität und Spezifität des Mini-Audio-Tests (MAT) für unterschiedliche Hörverlustschwellen

“…Weitere Behandlungsmöglichkeiten sind implantierbare Hörsysteme wie aktive Mittelohrimplantate, Knochenleitungs-oder Cochlea-Implantate [14]. Es konnte gezeigt werden, dass sich kognitive Leistungsverluste bei älteren Menschen bereits 6 Monate nach einer CI-Versorgung signifikant verbesserten [15].…”