Speech Recognition as a Function of Age and Listening Experience in Adult Cochlear Implant Users

Abstract

Objectives/hypothesis: Speech recognition with a cochlear implant (CI) tends to be better for younger adults than older adults. However, older adults may take longer to reach asymptotic performance than younger adults. The present study aimed to characterize speech recognition as a function of age at implantation and listening experience for adult CI users.

Study design: Retrospective review.

Methods: A retrospective review identified 352 adult CI recipients (387 ears) with at least 5 years of device listening experience. Speech recognition, as measured with consonant-nucleus-consonant (CNC) words in quiet and AzBio sentences in a 10-talker noise masker (10 dB signal-to-noise ratio), was reviewed at 1, 5, and 10 years postactivation.

Results: Speech recognition was better in younger listeners, and performance was stable or continued to improve through 10 years of CI listening experience. There was no indication of differences in acclimatization as a function of age at implantation. For the better performing CI recipients, an effect of age at implantation was more apparent for sentence recognition in noise than for word recognition in quiet.

Conclusions: Adult CI recipients across the age range examined here experience speech recognition benefit with a CI. However, older adults perform more poorly than young adults for speech recognition in quiet and noise, with similar age effects through 5 to 10 years of listening experience.

Level of evidence: 3 Laryngoscope, 131:2106-2111, 2021.

Keywords: Advanced age; cochlear implantation; geriatric; speech perception.

Figure 1.

Speech recognition performance on CNC words in quiet (top panel) and AzBio sentences in a 10-talker masker (10 dB SNR; bottom panel) for adult cochlear implant users as a function of listening experience (interval). Subjects listened with a hearing aid at the preoperative interval (open boxes) and with a CI-alone device at the post-activation intervals (filled boxes). Horizontal lines indicate the median, boxes span the 25^th to 75^th percentiles, and vertical lines span the 10^th to 90^th percentiles. The sample size is indicated above each individual box plot. CNC = consonant-nucleus-consonant; SNR = signal-to-noise ratio.

Figure 2.

Speech recognition performance on CNC words in quiet (top panel) and AzBio sentences in a 10-talker masker (10 dB SNR; middle panel) at 10 years post-activation as a function of age at implantation. The bottom panel shows word recognition scores for the 94 cases with data for both CNC words in quiet and AzBio sentences in noise (termed “better performers”). Solid lines depict the association between age at implantation and performance. Symbol fill indicates cases of unilateral and bilateral implantation, as defined in the legend. CNC = consonant-nucleus-consonant; SNR = signal-to-noise ratio.