Cochlear Implantation in Patients With Known Cognitive Impairment: What Are the Benefits?

Abstract

Objective: To evaluate the outcomes of cochlear implantation (CI) in adults with preoperatively diagnosed cognitive impairment.

Study design: Retrospective cohort study.

Setting: Tertiary-care academic center.

Patients: Adults undergoing CI with preexisting cognitive impairment.

Interventions: Cochlear implantation.

Main outcome measures: 1) Hearing improvement after CI; 2) morbidity and mortality associated with surgery.

Results: Eight patients met inclusion criteria with mean age 77.8 years (SD, 9.6 y) at time of implantation; 7 were included in subsequent analysis as one did not have speech recognition scores. Average preoperative MoCA cognitive score of 22.6 (SD, 3.9, ≤25 demonstrates cognitive impairment). Average follow-up was 29.0 months (SD, 33.3 mo). Two patients passed away at an average 58.0 months (SD, 31.1 mo) after surgery. Median preoperative pure tone average was 86.3 dB HL ( interquartile range 31.3 dB HL) compared with 33.8 dB HL (IQR 5.0 dB HL) postoperatively ( p = <0.001). Median preoperative speech testing score (AzBio/HINT) was 21% (IQR, 24%) compared with 44% (IQR, 21%) postoperatively ( p = <0.001). There were no observed surgical complications during the follow-up period.

Conclusions: This study demonstrates that patients with cognitive impairment before CI can experience improved hearing, no increased risk of complications, and good longevity after CI. Further prospective studies are needed to further define the utility of CI in patients with impaired cognition.