Does Age Impact Relative Baseline Performance and Improvement on Clinical Speech Recognition Tests in Adult Cochlear Implant Recipients?
Year: 2026
Type: article
Study design: Observational Study
Abstract: 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.
Source: Otology & Neurotology
Authors: Barak Spector, Katelyn A. Berg, Michael W. Canfarotta, Ankita Patro, Andrea Defreese, Marc L. Bennett, Susan Amberg, David S. Haynes, Nichole Dwyer, Taha A. Jan, Jourdan Holder, Matthew R. O’Malley, Brianna Sheckells, Elizabeth L. Perkins, Mackenzie Lighterink, Kareem O. Tawfik, Allyson Sisler-Dinwiddie, Tayler Sparrow, Noelle Steele, Sara Unrein, Terrin N. Tamati, Aaron C. Moberly
Institutions: Vanderbilt University Medical Center, Vanderbilt University
Language: English
Subfield: Cognitive Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: hybrid
OpenAlex ID: W7169789605