Cognitive Changes Up to 4 Years After Cochlear Implantation in Older Adults: A Prospective Longitudinal Study Using the RBANS-H.
Tinne Vandenbroeke, Ellen Andries, Marc J Lammers and 5 others
PMID 39228026WHAT IT FOUND
Cognitive scores improved significantly one year after cochlear implantation but returned to baseline levels by four years.
Quality of life and hearing gains persisted longer. Without a control group, practice effects from repeated testing may explain the early cognitive rise, so do not assume the implant caused lasting cognitive improvement.
Key findings
01Total cognitive scores improved significantly one year after activation but showed no significant difference compared to pre-operative baseline after four years.
02Health-related quality of life, specifically self-perceived hearing ability and social interaction, improved significantly at one year and remained significantly better than baseline at four years.
03Anxiety and depression scores decreased significantly at one year, but these improvements were no longer statistically significant when compared to pre-operative scores at four years.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study lacked a control group, so it is impossible to determine if the early cognitive improvements were due to the implant or simply practice effects from taking the same cognitive tests repeatedly. The sample size was small (25 participants), and several participants were lost to follow-up or declined specific tests over time, reducing the data available for some analyses. The participants received a bundle of interventions, including the implant, hearing aid fitting, speech therapy, and psychological counseling, making it difficult to isolate the effect of the implant alone. Important confounding factors for cognitive decline, such as hypertension, diabetes, and social isolation, were not controlled for in the analysis.
Declared interests
Two authors reported grants from Med-EL and Cochlear paid to the hospital. One author reported travel expenses reimbursed by MED-EL. Med-EL and Cochlear are major manufacturers of cochlear implants.
The easy way to misread this
Do not conclude that cochlear implants provide permanent protection against cognitive decline. The cognitive gains seen at one year disappeared by four years, and without a control group, those early gains may have been caused by familiarity with the test rather than the implant itself.