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. 2023 Mar 27;13(2):236-253.
doi: 10.3390/audiolres13020022.

Neuropsychological Functions and Audiological Findings in Elderly Cochlear Implant Users: The Role of Attention in Postoperative Performance

Ilaria Giallini  1 , Bianca Maria Serena Inguscio  1   2   3 , Maria Nicastri  1   2 , Ginevra Portanova  1   2 , Andrea Ciofalo  1 , Annalisa Pace  1   4 , Antonio Greco  1 , Hilal Dincer D'Alessandro  5 , Patrizia Mancini  1
Affiliations

Neuropsychological Functions and Audiological Findings in Elderly Cochlear Implant Users: The Role of Attention in Postoperative Performance

Ilaria Giallini et al. Audiol Res. .

Abstract

Objectives: The present study aimed to investigate in a group of elderly CI users working memory and attention, conventionally considered as predictors of better CI performance and to try to disentangle the effects of these cognitive domains on speech perception, finding potential markers of cognitive decline related to audiometric findings. Methods Thirty postlingually deafened CI users aged >60 underwent an audiological evaluation followed by a cognitive assessment of attention and verbal working memory. A correlation analysis was performed to evaluate the associations between cognitive variables while a simple regression investigated the relationships between cognitive and audiological variables. Comparative analysis was performed to compare variables on the basis of subjects' attention performance.

Results: Attention was found to play a significant role in sound field and speech perception. Univariate analysis found a significant difference between poor and high attention performers, while regression analysis showed that attention significantly predicted recognition of words presented at Signal/Noise +10. Further, the high attention performers showed significantly higher scores than low attentional performers for all working memory tasks.

Conclusion: Overall findings confirmed that a better cognitive performance may positively contribute to better speech perception outcomes, especially in complex listening situations. WM may play a crucial role in storage and processing of auditory-verbal stimuli and a robust attention may lead to better performance for speech perception in noise. Implementation of cognitive training in auditory rehabilitation of CI users should be investigated in order to improve cognitive and audiological performance in elderly CI users.

Keywords: attention; cochlear implantation; cognition; older adults; speech perception; working memory.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Scatterplot of audiological outcomes for words in three conditions: blue = quiet (Wq), green = SNR = +5 (W+5), and red = SNR+10 (W+10) as predicted by attention in the study sample (n = 30). Simple linear regression based on the RBANS score explained more than 50% of the variance for word recognition in noise.
Figure 2
Figure 2
Scatterplot of audiological outcomes for sentences in three conditions: blue = quiet (Sq), red = SNR = +10 (S+10), and green = SNR+5 (S+5) as predicted by attention in the study sample (n = 30). Simple linear regression based on the RBANS score explained more than 46% of the variance for sentence recognition in noise.
Figure 3
Figure 3
Scatterplot of audiological outcomes. Left: words in three conditions (blue = quiet (Wq), red = SNR = +10 (W+10), and green = SNR+5 (W+5)). Right: sentences in three conditions (blue = quiet (Sq), green = SNR = +10 (S+10), red = SNR+5 (S+5)) as predicted by WM in the study sample; scatterplots were produced without the contribution of outliers in the analysis: W+10 (R = 0.43, R2 = 0.19; p = 0.031) and W+5 (R = 0.47, R2 = 0.224; p = 0.019).
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