Does Age Impact Relative Baseline Performance and Improvement on Clinical Speech Recognition Tests in Adult Cochlear Implant Recipients?

OBJECTIVE

To examine the relative impact of advancing age on clinical speech recognition performance before and after cochlear implantation across tasks varying in auditory and cognitive demands.

STUDY

DESIGN

Retrospective review of prospectively collected data.

SETTING

Cochlear implant (CI) center.

PATIENTS: Seventy-five CI recipients aged 20 to 88 years (mean=67.6, SD: 15.8).

INTERVENTIONS: Speech recognition before and after CI.

MAIN OUTCOME MEASURES: Pre-CI performance and post-CI improvement on Consonant-Nucleus-Consonant (CNC) word recognition, AzBio sentences in quiet (AzBioQ), and AzBio sentences in noise (AzBioN); multivariate regression models accounting for relevant covariates.

RESULTS

Age negatively predicted pre-CI performance on AzBioQ (β=-0.18, P=0.025) and AzBioN (β=-0.17, P=0.024), but not CNC (β=0.00, P=0.988), when controlling for pure-tone average (PTA), duration of deafness (DoD), and sex. Older age predicted less post-CI improvement in AzBioN (β=-0.30, P=0.024), but not CNC (β=-0.24, P=0.054) or AzBioQ (β=-0.18, P=0.171), when controlling for DoD, CI usage, electrode type, and sex. Daily CI usage predicted post-CI improvement in CNC (β=3.80, P=0.001) and AzBioQ (β=3.07, P=0.009), but not AzBioN. Electrode type and sex were not significant predictors of post-CI improvements.

CONCLUSIONS

Advancing age is associated with poorer pre-CI sentence recognition and smaller gains in post-CI sentence recognition in noise, likely reflecting combined auditory and cognitive changes. These findings highlight the importance of age-informed counseling and expectation-setting for older CI candidates.

LEVEL OF EVIDENCE: Level IV-Historical cohort or case-controlled studies.

INDICATE IRB: 240876.