Cochlear implantation in the elderly using preoperative screening for mild cognitive impairment

What is it about?

In Germany, around 14 million people suffer from presbycusis, according to the WHO; more than a third of people over 65 worldwide are affected. Hearing loss often results in limited social participation, social withdrawal, isolation, and a negative impact on quality of life. The lack of acoustic stimuli and social interaction leads to the brain being under-challenged, resulting in an acceleration of cognitive decline and a drop in intellectual performance. In addition to an increased risk of dementia, an unfavorable influence on existing dementia is also described. To ensure social participation, maintain the ability to communicate, and continue to provide the brain with acoustic input advances in minimally invasive procedures made it possible for older people to be fitted with a cochlear implant (CI). In our study, in addition to the change in speech comprehension (measured using the Freiburg Speech Test pre- and postoperatively), we analyzed the cognitive performance before treatment with CI using the MoCA test. All patients over 65 years of age should be included regardless of their results in the MoCA.

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Photo by Matteo Vistocco on Unsplash

Photo by Matteo Vistocco on Unsplash

Why is it important?

We have currently included 27 patients in our study who scored 23.89±5.12 points in the MoCA. Preoperative aided speech understanding in percent was 12.04±16.66 at 65dB SPL resp. 27.50±24.20 at 80dB SPL. Postoperatively 6-12 months after initial activation the speech understanding in percent rose to 39.29±21.35 at 65dB SPL resp. 59.25±18.53 at 80dB SPL. We found a significant correlation (p=0.04; r=0.43; n=25) between the MoCA score and speech understanding preoperatively for 80dB SPL. Additionally, we found a significant improvement in speech understanding by CI at 65dB SPL in the speech test (p<0.01; t=-3.89; n=19) as well as at 80 dB SPL (p<0.01; t=-4.21; n=19).

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