Meta-Analysis of Speech Recognition Outcomes in Younger and Older Adults With Cochlear Implants

Abstract

Purpose Meta-analyses were conducted to compare pre- to postoperative speech recognition improvements and postoperative scores after cochlear implantation in younger (< 60 years) and older (> 60 years) adults. Method Studies were identified with electronic databases and through manual search of the literature. In the primary analyses, effect sizes between pre- and postoperative scores for each age group were calculated using a formula appropriate for repeated-measures designs. Using the effect sizes, two separate meta-analyses using a random-effects restricted maximum likelihood model were conducted for experiments using word and sentence recognition stimuli in quiet. Secondary meta-analyses were conducted to examine average postimplant, percent correct word recognition, sentence recognition, and speech recognition in noise in studies that included both older and younger age groups. Traditional Hedges's g effect sizes were calculated between the two groups. Results For the primary analyses, experiments using word and sentence recognition stimuli yielded significant, large effect sizes for the younger and older adult cochlear implant recipients with no significant differences between the older and younger age groups. However, the secondary meta-analyses of postoperative scores suggested significant differences between age groups for stimuli in quiet and noise. Conclusions Although older and younger adults with implants achieve the same magnitude of pre- to postimplant speech recognition benefit in quiet, the overall postoperative speech recognition outcomes in quiet and noise are superior in younger over older adults. Strategies to mitigate these group differences are critical for ensuring optimal outcomes in elderly individuals who are candidates for cochlear implants.

Learning to hear again with alternating cochlear frequency allocations

“…As discussed in Lambriks et al 1 , it can be argued that the absolute learning speed with either setting will be slower with this approach because the exposure is distributed over twice the amount of time. However, the final performance of our patients was in line with clinical populations, indicating that learning curves were not negatively influenced [17][18][19] . Possibly, selection bias might have occurred in our study population, as subject characteristics could potentially be different within the sample population that was willing to participate in the study compared to the clinical population.…”

The Effect of Aging on Auditory Nerve Function: Insights from Intraoperative eCAP Recordings in Cochlear Implant Users

“…It is noteworthy that although older adults appear to have poorer neural functioning than middle-aged and young adults (likely attributable to poorer neural survival), older adults receive similar benefit from cochlear implantation to their younger counterparts (3), and many obtain comparable speech recognition outcomes (4,5). This suggests that there must be robust neuroplasticity at higher levels of the auditory system to help these recipients overcome poorer peripheral processing.…”

“…Older cochlear implant (CI) recipients tend to have poorer speech recognition than their younger counterparts (1)(2)(3), although this finding is not unanimous (4,5). Age-related difficulties in speech recognition are likely due to changes in cognitive processing, peripheral auditory, and/or central auditory processing (e.g., [6]).…”

Effects of cochlear implantation on cognitive decline in older adults: A systematic review and meta-analysis

“…To systematically analyze the efficacy of CIs by considering differences in the characteristics of the studies, a meta-analysis including multiple studies could offer an alternative approach, although few such studies have been reported to date. However, even previously reported meta-analyses have primarily focused on comparing hearing-related abilities, such as speech perception, before and after CIs [ 14 , 28 ]. Very recently, a study investigating changes in cognitive function was published [ 29 ]; however, the number of studies included in the analysis was quite small (seven), and the analysis was based on limited cognitive tests.…”