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. 2023 Sep 14:15:1220184.
doi: 10.3389/fnagi.2023.1220184. eCollection 2023.

Longitudinal trajectories of memory among middle-aged and older people with hearing loss: the influence of cochlear implant use on cognitive functioning

Christiane Völter  1 , Lisa Götze  1 , Stefan Dazert  1 , Jan Peter Thomas  2 , Stefan Thomas Kamin  3
Affiliations

Longitudinal trajectories of memory among middle-aged and older people with hearing loss: the influence of cochlear implant use on cognitive functioning

Christiane Völter et al. Front Aging Neurosci. .

Abstract

Introduction: Cochlear implants (CI) are the gold standard intervention for severe to profound hearing loss, a known modifiable risk factor for dementia. However, it remains unknown whether CI use might prevent the age-related cognitive decline. Recent studies are encouraging but are limited, mainly by short follow-up periods and, for ethical reasons, lack of appropriate control groups. Further, as age-related cognitive decline is multifaceted and not linear, other statistical approaches have to be evaluated.

Materials and methods: Immediate and delayed recall as measures of cognitive function were assessed in 75 newly implanted CI users (mean age 65.41 years ± 9.19) for up to 5 years (mean 4.5 ± 0.5) of CI use and compared to 8,077 subjects of the same age range from two longitudinal cohort studies, the Health and Retirement Study (HRS) and the English Longitudinal Study of Aging (ELSA). Linear and quadratic changes in cognitive trajectories were analyzed in detail using mixed growth models, considering possible confounders.

Results: For CI users, the linear time slope showed a significant improvement in the specific domains (recall and delayed recall) over time. The quadratic time slope clearly indicated that the predicted change after CI provision followed an inverted U-shape with a predicted decline 2 years after CI provision. In the hearing-impaired group, a significant decline over time was found, with steeper declines early on and the tendency to flatten out in the follow-up.

Conclusion: Cochlear implant use seems to boost cognitive trajectories in the first years after implantation. However, long-term prevention of dementia seems to need far more than restoration of hearing loss.

Keywords: cochlear implantation; cognitive decline; dementia; hearing loss; multilevel growth model.

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Conflict of interest statement

CV, JT, and SD have received reimbursement of scientific meeting participation fees and accommodation expenses, as well as honoraria for preparing continuing medical education events and funding for research projects that they initiated, from MED-EL. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Predicted change in delayed and immediate recall by linear and quadratic time for both samples, adjusted for all covariates. T1 represents baseline data, T2 assessment 2, T3 the third and T4 the fourth measurement.
FIGURE 2
FIGURE 2
Predicted change in delayed and immediate recall by linear and quadratic time depending on hearing status, adjusted for all covariates. T1 represents baseline data, T2 assessment 2, T3 the third and T4 the fourth measurement.
See this image and copyright information in PMC

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