Cochlear implantation and cognitive function in the older adult population: current state of the art and future perspectives

Abstract

Objectives

Hearing loss is associated with increased cognitive decline and incident dementia in older adults. Given the rapidly rising incidence of dementia, management of modifiable risk factors such as hearing loss, is essential to mitigate the impact on the individual and society in general. In this narrative review, we discuss the current state-of-art with respect to studying cognitive function before and after cochlear implantation in the elderly population. Future perspectives are considered to shed light into the pathophysiology of cognitive decline due to hearing loss and how objective measures may contribute to this field.

Methods

The existing literature on cochlear implantation and cognition is reviewed. The potential limitations and objective measures for cognitive functioning are discussed. Relevant studies were identified through a broad search of academic databases, including Pubmed and Web of Science. Given the narrative nature of this review, no strict inclusion or exclusion criteria were applied, allowing for a broad overview of the current state-of-the-art literature on the effects of cochlear implantation on cognitive functioning, the challenges of studying cognition in this population and future research directions.

Results

Multiple studies have been able to demonstrate an improvement of cognitive functioning in older adults with severe-to-profound hearing loss after cochlear implantation. However, it is important to consider the challenges of studying cognition in this population. Evoked response potentials might have potential as an objective marker for cognition in this study population.

Conclusion

Although there is no standardized study protocol to investigate cognition after cochlear implantation, a significant improvement in cognition is observed in the majority of studies one year after cochlear implantation. The identification of an objective marker of cognitive functioning will help unravel how cochlear implantation affects cognition.