Imagine a superhero team, the Cochlear Crusaders, swooping in to save the day! Cochlear implants (CI) are like their superpower, helping combat severe to profound hearing loss and its associated risk factors for dementia. But can these Crusaders also prevent age-related cognitive decline? Recent studies have shown promise, but they were limited by short follow-up periods and the absence of appropriate control groups. We need more information and statistical approaches to fully understand the multifaceted nature of cognitive decline. In this study, researchers assessed cognitive function in 75 newly implanted CI users over a span of 5 years and compared them to a large cohort of individuals from two longitudinal studies. The results revealed that CI users experienced significant improvement in specific cognitive domains over time, with an inverted U-shaped trajectory suggesting a decline after 2 years of implantation. In contrast, the hearing-impaired group showed a steady decline, albeit with some flattening in the follow-up. This suggests that cochlear implant use can enhance cognitive trajectories initially, but long-term prevention of dementia may require additional interventions beyond restoring hearing loss. Excitingly, this research opens doors for exploring further ways to optimize cognitive functioning among individuals with hearing loss!

IntroductionCochlear implants (CI) are the gold standard intervention for severe to profound hearing loss, a known modifiable risk factor for dementia. However, it remains unknown whether CI use might prevent the age-related cognitive decline. Recent studies are encouraging but are limited, mainly by short follow-up periods and, for ethical reasons, lack of appropriate control groups. Further, as age-related cognitive decline is multifaceted and not linear, other statistical approaches have to be evaluated.Materials and methodsImmediate and delayed recall as measures of cognitive function were assessed in 75 newly implanted CI users (mean age 65.41 years ± 9.19) for up to 5 years (mean 4.5 ± 0.5) of CI use and compared to 8,077 subjects of the same age range from two longitudinal cohort studies, the Health and Retirement Study (HRS) and the English Longitudinal Study of Aging (ELSA). Linear and quadratic changes in cognitive trajectories were analyzed in detail using mixed growth models, considering possible confounders.ResultsFor CI users, the linear time slope showed a significant improvement in the specific domains (recall and delayed recall) over time. The quadratic time slope clearly indicated that the predicted change after CI provision followed an inverted U-shape with a predicted decline 2 years after CI provision. In the hearing-impaired group, a significant decline over time was found, with steeper declines early on and the tendency to flatten out in the follow-up.ConclusionCochlear implant use seems to boost cognitive trajectories in the first years after implantation. However, long-term prevention of dementia seems to need far more than restoration of hearing loss.

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