The Repeatable Battery for the Assessment of Neuropsychological Status for Hearing Impaired Individuals (RBANS-H) before and after Cochlear Implantation: A Protocol for a Prospective, Longitudinal Cohort Study

Abstract

Background: Currently, an independent relationship between hearing loss and cognitive decline in older adults is suggested by large prospective studies. In general, cochlear implants improve hearing and the quality of life in severely to profoundly hearing impaired older persons. However, little is known about the effects of cochlear implantation on the cognitive evolution in this population.Aim of the study: The primary goal of this prospective, longitudinal cohort study is to explore the cognitive profile of severely to profoundly postlingually hearing impaired subjects before and after cochlear implantation. In addition, the current study aims to investigate the relationship between the cognitive function, audiometric performances, quality of life, and self-reliance in these patients.Methods: Twenty-five patients aged 55 or older, scheduled for cochlear implantation, will be enrolled in the study. They will be examined prior to implantation, at 6 and 12 months after implantation and annually thereafter. The test battery consists of (1) a cognitive examination, using the Repeatable Battery for the Assessment of Neuropsychological Status adapted for Hearing impaired persons (RBANS-H), (2) an audiological examination, including unaided and aided pure tone audiometry, speech audiometry in quiet and speech audiometry in noise, (3) the administration of four questionnaires evaluating quality of life and subjective hearing benefit and (4) a semi-structured interview about the self-reliance of the participant.Discussion: Up until now only one study has been conducted on this topic, focusing on the short-term effects of cochlear implantation on cognition in older adults. The present study is the first study to apply a comprehensive neuropsychological assessment adapted for severely to profoundly hearing impaired subjects in order to investigate the cognitive capabilities before and after cochlear implantation.Trial registration: The present protocol is retrospectively registered at Clinical Trials (ClinicalTrials.gov) on June 9th, 2016. The first participant was enrolled on June 22nd, 2015. The protocol identifier is NCT02794350.

Does Treating Hearing Loss in Older Adults Improve Cognitive Outcomes? A Review

“…Future studies should make use of assessment tools suitable for people with a hearing impairment. It is noteworthy that two such tools have been recently developed: the Repeatable Battery for the Assessment of Neuropsychological Status for Hearing-Impaired individuals (RBANS-H) [38] providing audiovisual presentation of the instructions and the test items and the Hearing-Impaired Montreal Cognitive Assessment (HI-MoCA) [39], an adaptation of the MoCA. Nonetheless, if the explanation of possible testing biases can partly account for cross-sectional associations between hearing impairment and low cognitive performances in the studies consisting of comparing the cognitive scores of hearing-impaired participants to non-impaired ones, such potential biases alone can hardly explain the now numerous studies reporting accelerated decline, since in longitudinal studies the participant's performance is compared to his/her own over time and what is compared to a control group is the rate of decline, not inter-individual performance.…”

Can cochlear implantation improve neurocognition in the aging population?

“… 35 However, Sonnet et al did not detect an improvement in global cognition by the Mini-Mental State Examination in 16 persons, whereas there was an amelioration in the executive functions evaluated by the Instrumental Activities of Daily Living. 36 More recently, a longitudinal cohort study on cognitive functioning of 25 CI candidates in the short- and long-term follow-up has been proposed by Claes et al 37 …”

Does Otovestibular Loss in the Autosomal Dominant Disorder DFNA9 Have an Impact of on Cognition? A Systematic Review

“…Numerous studies have already described the correlation between hearing impairment and cognitive decline. (Fulton et al, 2015 ; Miller et al, 2015 ; Castiglione et al, 2016 ; Claes et al, 2016 ) In DFNA9 patients, the impact on QoL of SNHL and cochlear implantation was studied, without focusing on cognitive impairment (Vermeire et al, 2006 ; Castiglione et al, 2016 ). No data were available on the evaluation of cognition in DFNA9 patients or BVL in general at the time of the literature search.…”

“…Several studies have been conducted on the impact of hearing loss on cognition (Lin et al, 2013 ; Fulton et al, 2015 ; Miller et al, 2015 ; Castiglione et al, 2016 ; Claes et al, 2016 ). Lin et al performed a large prospective study with 1,984 older adults of which there were 1,162 hearing impaired.…”

“…(Popp et al, 2017 ) Both MDRS and RBANS require verbal communication with the patient, which makes the results questionable when used in studies including patients with hearing impairment (Appels and Scherder, 2010 ). However, an adjusted version of the RBANS, the RBANS-H, has been drafted especially for patients with impaired hearing, overcoming the bias caused by hearing impairment within these cognitive assessment tools (Claes et al, 2016 ).…”