Cognitive Changes Up to 4 Years After Cochlear Implantation in Older Adults: A Prospective Longitudinal Study Using the RBANS-H.

IF 2.6 2区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY
Ear and Hearing Pub Date : 2025-03-01 Epub Date: 2024-09-04 DOI:10.1097/AUD.0000000000001583
Tinne Vandenbroeke, Ellen Andries, Marc J Lammers, Paul Van de Heyning, Anouk Hofkens-Van den Brandt, Olivier Vanderveken, Vincent Van Rompaey, Griet Mertens
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引用次数: 0

Abstract

Objectives: Hearing loss is a worldwide health problem that currently affects around 20% of the world's population. Untreated hearing loss can have a significant impact on daily life, it can cause social isolation, loneliness, frustration, and higher anxiety and depression rates. Furthermore, older adults with hearing impairment have a higher risk for accelerated cognitive decline compared with normal-hearing individuals. Previous research indicated a positive effect of cochlear implantation on Health-related Quality of life (HRQoL) and cognitive functioning 1 year after cochlear implantation. The aim of this study was to evaluate the long-term effect of cochlear implantation on cognition and HRQoL in older adults with severe-to-profound hearing loss.

Design: All included subjects were 55 years or older with postlingual, bilateral, severe-to-profound hearing loss, and received a unilateral cochlear implant. Cognition was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status for Hearing Impaired Individuals (RBANS-H), and HRQoL was evaluated using the following five questionnaires: Nijmegen Cochlear Implant Questionnaire (NCIQ); Hearing Implant Sound Quality Index (HISQUI); Speech, Spatial, and Qualities of Hearing Scale (SSQ12); Hospital Anxiety and Depression scale (HADS); and Type D questionnaire (DS14). Individuals were evaluated preoperatively, and annually up to 4 years after CI activation.

Results: After cochlear implantation an improvement in hearing, cognition, and HRQoL was observed. When comparing preoperative and 12 months postoperative results a significant improvement was observed in the total RBANS-H score (mean [SD], 92.78 [±15.08] versus 98.35 [±14.18], p < 0.001) and the subdomain scores for "Immediate Memory" (94.13 [±18.75] versus 105.39 [±19.98], p = 0.005), "Attention" (86.17 [±19.02] versus 91.57 [±15.35], p = 0.048), and "Delayed memory" (97.91 [±14.51] versus 103.83 [±14.714], p = 0.017). When comparing preoperative results with 4 years postoperative results, a significant improvement was observed in "Immediate Memory" (94.13 [±18.75] versus 101.91 [±16.09], p = 0.020) and a significant decline was observed in "Visuospatial Memory" (97.04 [±17.47] versus 87.26 [±13.41], p = 0.013). Compared with the preoperative results, no significant improvement was observed in the total RBANS-H score 4 years after implantation. A significant improvement was observed for the HRQoL questionnaires, that is, NCIQ, HISQUI19, SSQ12, HADS, and DS14, 1 year after cochlear implantation. When comparing preoperative results with 4-year postoperative results, significant improvement was observed for the NCIQ and DS14 social inhibition scores. Long-term results of the SSQ12 and HISQUI19 were lacking.

Conclusions: Unilateral cochlear implantation in an adult population with bilateral severe-to-profound sensorineural hearing loss has a positive effect on cognitive functioning and HRQoL 1 year after activation. This positive effect on cognitive functioning was no longer observed 4 years after cochlear implantation. Further research is needed to explain individual variation in the evolution of cognitive functioning.

老年人植入人工耳蜗后 4 年的认知变化:使用 RBANS-H 的前瞻性纵向研究。
目的:听力损失是一个世界性的健康问题,目前约有 20% 的世界人口受到影响。听力损失如不及时治疗,会对日常生活造成严重影响,导致社交孤立、孤独、沮丧以及焦虑和抑郁率升高。此外,与听力正常的人相比,患有听力障碍的老年人认知能力加速衰退的风险更高。以前的研究表明,人工耳蜗植入对健康相关生活质量(HRQoL)和人工耳蜗植入 1 年后的认知功能有积极影响。本研究旨在评估人工耳蜗植入对患有重度至永久性听力损失的老年人的认知能力和 HRQoL 的长期影响:设计:所有受试者均为 55 岁或 55 岁以上,患有舌后、双侧、重度至永久性听力损失,并接受了单侧人工耳蜗植入。认知能力使用听力受损者神经心理状态评估可重复电池(RBANS-H)进行评估,而 HRQoL 则使用以下五种问卷进行评估:奈梅亨人工耳蜗问卷 (NCIQ);听力植入声音质量指数 (HISQUI);言语、空间和听力质量量表 (SSQ12);医院焦虑和抑郁量表 (HADS);以及 D 型问卷 (DS14)。对患者进行术前评估,并在人工耳蜗激活后 4 年内每年进行一次评估:结果:人工耳蜗植入术后,听力、认知能力和 HRQoL 均有改善。比较术前和术后 12 个月的结果,RBANS-H 总分(平均值 [SD], 92.78 [±15.08] 对 98.35 [±14.18], p < 0.001)和 "即时记忆 "子域得分(94.13[±18.75]对 105.39[±19.98],p = 0.005)、"注意力"(86.17[±19.02]对 91.57[±15.35],p = 0.048)和 "延迟记忆"(97.91[±14.51]对 103.83[±14.714],p = 0.017)的分域得分。将术前结果与术后 4 年的结果进行比较,可以观察到 "即时记忆 "显著改善(94.13 [±18.75] 对 101.91 [±16.09],p = 0.020),而 "视觉空间记忆 "显著下降(97.04 [±17.47] 对 87.26 [±13.41],p = 0.013)。与术前结果相比,植入 4 年后的 RBANS-H 总分没有明显改善。人工耳蜗植入 1 年后,HRQoL 问卷,即 NCIQ、HISQUI19、SSQ12、HADS 和 DS14 均有明显改善。将术前结果与术后 4 年的结果进行比较后发现,NCIQ 和 DS14 社交抑制得分有显著改善。SSQ12和HISQUI19的长期结果尚缺:结论:对患有双侧重度至永久性感音神经性听力损失的成人进行单侧人工耳蜗植入,对激活后 1 年的认知功能和 HRQoL 有积极影响。人工耳蜗植入 4 年后,这种对认知功能的积极影响不再被观察到。要解释认知功能演变过程中的个体差异,还需要进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Ear and Hearing
Ear and Hearing 医学-耳鼻喉科学
CiteScore
5.90
自引率
10.80%
发文量
207
审稿时长
6-12 weeks
期刊介绍: From the basic science of hearing and balance disorders to auditory electrophysiology to amplification and the psychological factors of hearing loss, Ear and Hearing covers all aspects of auditory and vestibular disorders. This multidisciplinary journal consolidates the various factors that contribute to identification, remediation, and audiologic and vestibular rehabilitation. It is the one journal that serves the diverse interest of all members of this professional community -- otologists, audiologists, educators, and to those involved in the design, manufacture, and distribution of amplification systems. The original articles published in the journal focus on assessment, diagnosis, and management of auditory and vestibular disorders.
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