Author(s)
Christi A. Joyce
Kelly Zhang
Joost J.A. Stulteins, MD
Alexandra E. Quimby, MD, MPH
Affiliation(s)
Dalhousie University
Abstract:
Objective: To assess whether cochlear implantation (CI) affects cognitive function in older adults.
Data Sources: MEDLINE, Embase, Cochrane CENTRAL, Web of Science, PsycINFO, and CINAHL.
Study Selection: Two reviewers independently screened studies. Eligible studies were published in English language, included adults aged =60 years of age with post-lingual hearing loss who had undergone CI, and reported both pre- and post-CI objective cognitive assessment scores. Interventional studies, cohorts, case-controls, and case series with n>5 were included.
Data Extraction: Data from included studies were independently extracted by two reviewers. Study quality and risk of bias were evaluated.
Data Synthesis: Within subjects random effects meta-analysis was performed using the methodology of DerSimonian/ Laird. Separate meta-analyses were performed including studies reporting mean pre- and post-CI scores on the same cognitive test (for tests that were reported in > 3 studies). Meta-analysis of standardized mean differences (SMD) was additionally performed considering the findings across all studies and reported tests.
Results: Twenty-five eligible studies were identified, including a total of 997 patients. Sixty-three separate cognitive tests were applied (including components of cognitive testing batteries) at a mean 14.55 months post-operatively. The most commonly applied was the Mini Mental Status Exam (MMSE) (9 studies). Meta-analysis of mean differences showed no significant effect of CI on MMSE score (mean difference= 0.64, 95% CI=-0.66, 1.95). Considering all studies, there was a small improvement in mean cognitive testing scores post-CI (pooled SMD=0.152, 95% CI= 0.033, 0.271).
Conclusions: CI may improve cognitive function in implanted older adults. Further research using uniform measurement tools is needed to better clarify this finding.
Learning Objective: Understand current evidence on the effect of cochlear implantation on cognitive function in older adults. Discuss implications of cochlear implantation for mitigating cognitive decline and promoting healthy aging.
Desired Result: This study aims to enhance physicians’ understanding of the benefits associated with cochlear implantation in older adults. It is expected to increase competence in integrating cognitive outcomes into cochlear implant counseling, and ultimately support timely interventions that may contribute to improved patient outcomes through preservation of cognitive function and quality of life.
Level of Evidence - Level I
Indicate IRB or IACUC: Exempt.