The Impact of Cochlear Implantation: Cognitive Function, Quality of Life, and Frailty in Older Adults

Abstract

This review examines the relationship between cochlear implantation and cognition and quality of life in older adults, as well as how frailty affects outcomes for older patients with cochlear implants. A growing body of evidence suggests that there is a strong association between hearing loss and cognitive impairment. Preliminary studies suggest that cochlear implantation in older adults may be protective against cognitive decline. While studies have observed a positive impact of cochlear implantation on quality of life, currently it is unclear what factors contribute the most to improved quality of life. Frailty, as a measurement of general health, likely plays a role in complication rates and quality-of-life outcomes after cochlear implantation, though larger prospective studies are required to further elucidate this relationship.

Effects of auditory rehabilitation with cochlear implant on tinnitus prevalence and distress, health-related quality of life, subjective hearing and psychological comorbidities: Comparative analysis of patients with asymmetric hearing loss (AHL), double-sided (bilateral) deafness (DSD), and single-sided (unilateral) deafness (SSD)

“…The subjective hearing was measured with the short version of OI (34) that has 12 questions and three scales: (1) listening in a quiet setting (questions 1, 3, 5, 7), (2) listening with background noise (4,6,8,11,12), (3) directional listening (2, 9, 10). Responses to each of the 12 questions were rated 1 to 5 points.…”

“…Cochlear implantation improves general hearing abilities, speech perception, and sound localization in patients with asymmetric hearing loss (AHL) ( 2 ), single-sided (unilateral) deafness (SSD) ( 3 ), and double-sided (bilateral) deafness (DSD) ( 4 ). Accumulating evidence suggests that the beneficial effects of implantation extend beyond the main indication (improvement of auditory abilities) and can positively impact cognition ( 5 – 7 ), health-related quality of life ( 6 , 8 ), and comorbid symptoms such as depression or anxiety ( 9 ). Additionally, the predominantly positive influence of implantation on tinnitus presence and tinnitus-induced distress is well-documented ( 9 , 10 ), although the exact mechanism of this phenomenon is still not fully understood.…”

Morphometric Analysis and Linear Measurements of the Scala Tympani and Implications in Cochlear Implant Electrodes

“…Patients with moderate to profound bilateral sensorineural hearing loss, who demonstrate inadequate benefit from hearing amplification, may benefit from cochlear implantation, which has now become the standard of care and has been shown to improve global cognitive function, quality of life scores, and other long-term benefits (1)(2)(3). Recently, efforts have focused on performing implantation as atraumatically as possible, for residual hearing preservation and minimalization of triggers of fibrosis (4,5).…”

Do Patients Aged 85 Years and above Benefit from Their Cochlear Implants?

“…Figure 10 shows how much their remaining hearing difficulties disturbed their activity capacity during the last two weeks. Four patients out of the forty-three included in the study canceled appointments at the clinic due to health-related issues that made it difficult to travel to the clinic (3) and the severe sickness of the patient's spouse (1). None of those four are among the patients with a change in the MSword score of more than 20 percentage points, as shown in Table 1.…”

“…The population in the world grows older, and age-related hearing loss is known to substantially impact quality of life [1,2]. Studies have found that the incidence of dementia is higher in people with self-reported hearing problems compared to hearing aid users or cochlear implant users [3].…”