ORCID Profile
0000-0001-5814-4355
Current Organisations
Ear Science Institute Australia
,
University of Western Australia
,
Western Australian Centre for Health and Ageing
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Publications
Relationship of age-related hearing loss with cognitive decline and dementia in Sinitic tonal language-speaking populations: protocol for a systematic review and meta-analysis
Publisher: BMJ
Date: 04-2022
DOI: 10.1136/BMJOPEN-2022-060901
Abstract: Existing research on the potential association between age-related hearing loss (ARHL) and cognitive decline and dementia in tonal language-speaking populations is limited and inconsistent. There is psychophysiological evidence suggesting a tonal language background may be linked to enhanced general cognitive functions. We aim to systematically review the current evidence on the association between hearing loss and cognitive impairment/decline and dementia in older adults who speak a Sinitic tonal language, the most commonly spoken tonal language. This systematic review will consider peer-reviewed articles that employ objective or subjective hearing measurement and cognitive impairment or diagnosis of dementia. All relevant research publications in English or Chinese and published up to March 2022 will be considered for inclusion. Embase, MEDLINE, Web of Science, PsycINFO Google Scholar, SinoMed and Chinese Biomedical Database will be used, using both medical subject heading terms and keywords. The quality of evidence of an association between ARHL and cognitive impairment and/or dementia will be evaluated by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. A random-effects meta-analysis will be carried out with the Comprehensive Meta-Analysis software. Ethical approval will not be required for this systematic review. The results will be disseminated through peer-reviewed publications and conferences. CRD42021235310.
Predicting sequential bilateral cochlear implantation performance in postlingually deafened adults; A retrospective cohort study
Publisher: Wiley
Date: 28-08-2018
DOI: 10.1111/COA.13193
Abstract: To identify which preoperative patient characteristics influence sequential bilateral cochlear implantation performance and to create a statistical model that predicts benefit. Multicentre retrospective cohort study. All patients were operated in four academic teaching hospitals in Perth, Australia, and followed up by audiologists of the Ear Science Institute Australia. A total of 92 postlingually deafened adult patients who had undergone sequential cochlear implantations between 19 June 1990 and 14 March 2016 were included. Patients were excluded if the 12-month follow-up consonant-nucleus-consonant (CNC) phoneme score was missing. The effect of 18 preoperative factors on the CNC phoneme score in quiet (at 65 dB SPL) with the second cochlear implant (CI2) one year after implantation. Two factors were positively correlated to speech understanding with CI2: Wearing a hearing aid (HA) before receiving CI2 (r = 0.46, P = 0.00) and the maximum CNC phoneme score with the first CI (CI1) (r = 0.21, P = 0.05). Two factors were negatively correlated: the length of hearing loss before CI2 in the second implanted ear (r = -0.25, P = 0.02) and preoperative pure tone average (PTA) (0.5, 1, 2 kHz) before CI2 in the second implanted ear (r = -0.27, P = 0.01). The following model could be created: predicted CNC phoneme score with CI2 (%) = 16 + (44 * HA use before CI2 (yes)) - (0.22 * length of hearing loss before CI2 (years)) + (0.23 * CNC phoneme score with CI1 (%)). Because the effect of HA use before implantation played such a major role, we also created a model after exclusion of the HA factor: Predicted CNC phoneme score with CI2 (%) = 82 - (0.17 * length of hearing loss before CI2 (years)) - (0.27 * PTA in second implanted ear before CI2 (0.5, 1, 2 kHz)) + (0.20 * CNC phoneme score with CI1 (%)). Advanced age or a long interval between implantations does not necessarily lead to poor CI2 results. Patients who are successful HA users before CI2, who have a low PTA before CI2, a high CNC phoneme score with CI1 and a limited length of hearing loss before CI2, are likely to be successful CI2 recipients.
Auditory electrophysiological assessments of Alzheimer’s disease and preclinical stages: protocol for a systematic review and meta-analysis
Publisher: BMJ
Date: 07-2020
DOI: 10.1136/BMJOPEN-2019-033308
Abstract: Investigating auditory functions in populations at risk of developing Alzheimer’s disease (AD) using auditory neurophysiological measurements can potentially identify a crucial and sensitive diagnostic window of opportunity in preclinical AD. Auditory electrophysiological assessments have gained interest as possible tools for early diagnosis of AD. This paper outlines the protocol that will be used to systematically review the published literature currently available on auditory electrophysiological assessments that have been used to assess the auditory functions of adults over the age of 60 years diagnosed with AD or its preclinical stages. All full-length peer-reviewed publications of original data that use auditory electrophysiological assessments in AD and its preclinical stages (subjective cognitive decline (SCD) and mild cognitive impairment (MCI)) will be considered in this review. The search will be performed on major electronic databases (Ovid MEDLINE, Ovid Embase, PsycINFO, PubMed, Scopus and CINAHL Plus) using keywords alone or in combination with Medical Subject Headings ided into two domains (i) auditory tests and (ii) AD. The database search will be conducted on the 7 th of May 2019. Data analysis will be completed and reported in the full review. A random effects meta-analysis will also be conducted using the Comprehensive Meta-Analysis software, V.3. This review will describe which auditory electrophysiological tests have been found to be useful in assessing the auditory function in cognitively impaired adults (MCI and AD) or adults with serious complaints about their cognition (SCD). This review will also identify and describe which auditory electrophysiological test demonstrates the most sensitivity in differentiating people at different stages of cognitive decline. This systematic review focusses on analysing already available literature. Therefore, there will be no requirement for ethical approval. The systematic review findings will be disseminated through peer-reviewed publication as well as relevant media platforms, for ex le, conferences. PROSPERO CRD42019133553.
Auditory and Cognitive Training for Cognition in Adults With Hearing Loss
Publisher: SAGE Publications
Date: 2018
Australian older adults' views on using social media for reducing social isolation and loneliness in hearing impaired older adults
Publisher: Wiley
Date: 12-09-2022
DOI: 10.1111/AJAG.13137
Abstract: The objective of this study was to conduct a community conversation to identify the views of the community members when designing an online community using Facebook to support the psychosocial well‐being of hearing‐impaired older adults. A community conversation was held with 40 older adults aged more than 60 years. The participants were ided into groups of five and asked to discuss three open‐ended questions. The researchers facilitated the discussions. The overwhelming response from this group was that they did not use Facebook or social media as a tool for social connection and did not see the benefits of social media applications. They preferred phone calls or in‐person events to maintain their social relationships. Implications for areas of future research and interventions that target loneliness in older adults are discussed.
The Relationship Between Hearing Loss and Cognitive Impairment in a Chinese Elderly Population: The Baseline Analysis
Publisher: Frontiers Media SA
Date: 26-11-2021
DOI: 10.3389/FNINS.2021.749273
Abstract: Objectives: The objective of the study was to investigate the association between untreated age-related hearing loss and cognitive impairment in Mandarin-speaking older adults living in China. Methods: Older adults (293 111 males, M = 70.33 ± 4.90 years 182 females, M = 69.02 ± 4.08 years) were recruited. All participants completed a pure tone audiometric hearing assessment, Hearing Impairment-Montreal Cognitive Assessment Test (HI-MoCA), and a computerized neuropsychology test battery (CANTAB). The Mandarin version of the De Jong Gierveld Loneliness Scale was used to measure the loneliness, and the Mandarin version of the 21-item Depression Anxiety Stress Scale (DASS-21) was used to measure the current severity of a range of symptoms common to depression, stress, and anxiety of the participants. Results: A multiple stepwise regression analysis showed that the average of four mid-frequency thresholds in the better ear was related to CANTAB Paired Associates Learning (β = 0.20, p = 0.002), and the global cognitive function score (HI-MoCA) (β = −0.25, p & 0.001). The average of three high frequencies in the better ear was significantly associated with CANTAB Delayed Matching to S le (β = −0.16, p = 0.008), and Spatial Working Memory (β = 0.17, p = 0.003). Conclusion: The results revealed a significant relationship between age-related hearing loss and cognitive impairment in Mandarin-speaking older adults. These research outcomes have clinical implications specifically for hearing health care professionals in China and other populations that speak a tonal language, especially when providing hearing rehabilitation.
Comparison of Auditory Steady-State Responses with conventional audiometry in Older Adults
Publisher: Frontiers Media SA
Date: 04-07-2022
DOI: 10.3389/FNEUR.2022.924096
Abstract: Behavioral measures, such as pure-tone audiometry (PTA), are commonly used to determine hearing thresholds, however, PTA does not always provide reliable hearing information in difficult to test in iduals. Therefore, objective measures of hearing sensitivity that require little-to-no active participation from an in idual are needed to facilitate the detection and treatment of hearing loss in difficult to test people. Investigation of the reliability of the auditory steady-state response (ASSR) for measuring hearing thresholds in older adults is limited. This study aimed to investigate if ASSR can be a reliable, objective measure of frequency specific hearing thresholds in older adults. Hearing thresholds were tested at 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz in 50 participants aged between 60 and 85 years old, using automated PTA and ASSR. Hearing thresholds obtained from PTA and ASSR were found to be significantly correlated (p & .001) in a cohort consisting of participants with normal hearing or mild hearing loss. ASSR thresholds were significantly higher as compared to PTA thresholds, but for the majority of cases the difference remained within the clinically acceptable range (15 dB). This study provides some evidence to suggest that ASSR can be a valuable tool for estimating objective frequency-specific hearing thresholds in older adults and indicate that ASSR could be useful in creating hearing treatment plans for older adults who are unable to complete behavioral PTA. Further research on older adults is required to improve the methodological features of ASSR to increase consistency and reliability, as well as minimize some of the limitations associated with this technique.
Impact of aging on the auditory system and related cognitive functions
Publisher: Frontiers Media SA
Date: 05-03-2018
Peripheral Hearing Loss and Its Association with Cognition among Ethnic Chinese Older Adults
Publisher: S. Karger AG
Date: 2021
DOI: 10.1159/000519291
Abstract: b i Introduction: /i /b Many studies on hearing loss (HL) and cognition are limited by subjective hearing assessments and verbally administered cognition tests, the majority of the document findings in Western populations. This study aimed to assess the association of HL with cognitive impairment among ethnic Chinese Singaporean older adults using visually presented cognitive tests. b i Methods: /i /b The hearing of community-dwelling older adults was assessed using pure tone audiometry. Cognitive function was assessed using the Computerized Cambridge Cognitive Test Battery (CANTAB). Multiple regression analyses examined the association between hearing and cognitive function, adjusted for age, education, and gender. b i Results: /i /b HL (pure-tone average [PTA] of thresholds at 0.5, 1, 2, and 4 kHz in the better ear, BE4PTA) was associated with reduced performance in delayed matching and multitasking tasks (β = −0.25, i /i = 0.019, and β = 0.02, i /i = 0.023, respectively). Moderate to severe HL was associated with reduced performance in delayed matching and verbal recall memory tasks (β = −10.6, i /i = 0.019, and β = −0.28, i /i = 0.042). High-frequency HL was associated with reduced performance in the spatial working memory task (β = 0.004, i /i = 0.022). All-frequency HL was associated with reduced performance in spatial working memory and multitasking (β = 0.01, i /i = 0.040, and β = 0.02, i /i = 0.048). b i Conclusion: /i /b Similar to Western populations, HL among tonal language-speaking ethnic Chinese was associated with worse performance in tasks requiring working memory and executive function.
Validation of teleaudiology hearing aid rehabilitation services for adults
Publisher: Informa UK Limited
Date: 31-03-2022
DOI: 10.1080/09638288.2021.1900928
Abstract: To investigate outcome measurement tools for the validation of teleaudiology hearing aid rehabilitation services for adults. A search strategy was developed to identify tools used to evaluate standard and teleaudiology hearing aid rehabilitation services for adults. A seven-domain hearing-health-care service model for validation was defined and used to analyse the applicability and suitability of patient- and service-centred tools. This model and the applicability and suitability criteria were based on the literature, the International Classification of Functioning (ICF) framework, and gold standard professional practice guidelines, which together formed the validation framework used in this study. Eighteen tools were identified and assessed against the validation framework. These tools were found to primarily assess aspects in the patient communication domain and rarely in the domain of service provision. All the included tools had some applicable items for teleaudiology hearing aid services three tools were judged as suitable and four partially suitable for validating these services. Although there is a set of suitable tools available to validate teleaudiology hearing aid rehabilitation services, none of them cover all the seven domains of the validation model used by this review and few are focussed on a specific domain. Further improvement and/or development of new tools to comprehensively validate these services is still necessary. At this stage, this still limits clinical audiology practice research, especially in teleaudiology.IMPLICATIONS FOR REHABILITATIONOutcome measurement tools are crucial for assessing the validity of hearing rehabilitation services.Findings of this study inform clinicians and researchers on how and what to assess and use to evaluate teleaudiology and standard hearing aid rehabilitation services.The use of the proposed validation framework may facilitate the standardisation of validation of both face-to-face and remotely delivered audiology rehabilitation services and improve consistency of methodology and reported real-world outcomes across studies and thus, the evidence.
The Relationship of Age-Related Hearing Loss with Cognitive Decline and Dementia in a Sinitic Language-Speaking Adult Population: A Systematic Review and Meta-Analysis
Publisher: Oxford University Press (OUP)
Date: 20-12-2023
Abstract: Substantial evidence supports the association between untreated hearing loss, cognitive decline, and dementia in the non-tonal language-speaking population. Whether a similar association between hearing loss and cognitive decline and dementia exists in Sinitic tonal language-speaking people is yet to be elucidated. We aimed to systematically review the current evidence on the association between hearing loss and cognitive impairment/decline, and dementia in older adults who speak a Sinitic tonal language. This systematic review considered peer-reviewed articles that employed objective or subjective hearing measurement and cognitive function, cognitive impairment, or diagnosis of dementia. All articles written in English and Chinese and published before March 2022 were included. Databases including Embase, MEDLINE, Web of Science, PsycINFO and Google Scholar, SinoMed, and CBM were utilized using MeSH terms and keywords. Thirty-five articles met our inclusion criteria. Of these, 29 unique studies with an estimated 372,154 participants were included in the meta-analyses. Among all included studies, the effect size of cognitive function with hearing loss, the regression coefficient was −0.26 (95% confidence interval [CI], −0.45 to −0.07). Among cross-sectional and cohort studies, a significant association was found between hearing loss and cognitive impairment and dementia, with odds ratios of 1.85 (95% CI, 1.59–2.17) and 1.89 (95% CI, 1.50–2.38), respectively. Most of the studies included in this systematic review observed a significant association between hearing loss and cognitive impairment and dementia. There was no significant difference to the findings in non-tonal language populations.
The longitudinal relationship between hearing loss and cognitive decline in tonal language-speaking older adults in China
Publisher: Frontiers Media SA
Date: 17-03-2023
A novel study on association between untreated hearing loss and cognitive functions of older adults: Baseline non‐verbal cognitive assessment results
Publisher: Wiley
Date: 08-2018
DOI: 10.1111/COA.12937
Abstract: Age-related hearing loss (ARHL) is highly prevalent in older adults, and more than two-thirds above age of 70 years suffer from ARHL. Recent studies have established a link between ARHL and cognitive impairment however, most of the studies have used verbally loaded cognitive measures to investigate the association between ARHL and cognition. It is possible that due to hearing impairment, the elderly may experience difficulty in following verbal instructions or completing tasks that heavily rely on hearing during cognitive assessments. This may result in overestimation of cognitive impairment in such in iduals. This baseline cross-sectional study investigated the associations between untreated hearing loss and a number of cognitive functions using a battery of non-verbal cognitive tests. Further, association between hearing loss and psychological status of older adults was examined. Prospective case-controlled study. A total of 119 participants (54 males, M=66.33±10.50 years 65 females M=61.51±11.46 years) were recruited. All participants completed a hearing assessment, a computerised test battery of non-verbal cognitive functions and the depression, anxiety and stress scale. Hierarchical multiple regression analysis results revealed that hearing thresholds significantly associated with the working memory (P<0.05), paired associative learning scores (P<0.05), depression (P<0.001), and anxiety (P<0.001) and stress (P<0.001) scores. Analysis of covariance results revealed that participants with moderately-severe hearing loss performed significantly poorer in paired associative learning and working memory tasks and psychological function tests compared to those with normal hearing. Results of the current study suggest a significant relationship between ARHL and both cognition and psychological status. Our results also have some implications for using non-verbal cognitive tests to evaluate cognitive functions in post-lingually hearing impaired ageing adults, at least for those with more than moderately-severe levels of hearing loss.
The Development of a Pitch Training Program for Adult Cochlear Implant and Hearing Aid Users
Publisher: Georg Thieme Verlag KG
Date: 19-11-2012
The impact of untreated hearing loss on depression, anxiety, stress, and loneliness in tonal language-speaking older adults in China
Publisher: Frontiers Media SA
Date: 12-2022
DOI: 10.3389/FPSYG.2022.917276
Abstract: Age-related hearing loss, mental health conditions, and loneliness commonly affect older adults. This study aimed to determine whether untreated hearing loss is independently associated with depression, anxiety, stress, and loneliness in tonal language-speaking older adults in China. Observational, cross-sectional study. 293 older adults (111 males, M = 70.33 ± 4.90 years 182 females, M = 69.02 ± 4.08 years) were recruited. All participants completed a pure tone audiometric hearing assessment, and provided information on living arrangements, marital status, leisure activities, tobacco and alcohol use, and medical history. The Mandarin version of the De Jong Gierveld Loneliness Scale was used to measure loneliness, and the Mandarin version of the 21-item Depression Anxiety Stress Scale (DASS-21) was used to assess a range of symptoms common to depression, stress, and anxiety of the participants. The analysis focused on determining the predictors of depression, anxiety, and stress, and the predictors of measures of loneliness. Multiple stepwise regression analyses revealed that the emotional loneliness ( β = 0.303 , p & 0.001) and living status ( β = 0.110, p = 0.048) significantly predicted DASS depression scores emotional loneliness ( β = 0.276, p & 0.001) and a history of vascular disease ( β = 0.148, p = 0.009) were significantly related to DASS anxiety scores emotional loneliness ( β = 0.341, p & 0.001) and a history of vascular disease ( β = 0.129, p = 0.019) significantly predicted DASS stress scores. Furthermore, multiple stepwise regression analyses showed that DASS stress scores ( β = 0.333, p & 0.001), education years ( β = −0.126, p = 0.020), marriage status ( β = 0.122, p = 0.024), and a history of vascular disease ( β = 0.111, p = 0.044) significantly predicted emotional loneliness four-frequency average hearing loss ( β = 0.149, p = 0.010) and DASS stress scores ( β = 0.123, p = 0.034) significantly predicted social loneliness scale and four-frequency average hearing loss ( β = 0.167, p = 0.003) and DASS stress scores ( β = 0.279, p & 0.001) also significantly predicted overall loneliness. There were no significant associations with high-frequency hearing loss. This study revealed that loneliness has a significant relationship both with hearing loss and aspects of mental health in an older adult Mandarin-speaking population. However, mental health was not significantly associated with hearing loss in this population.
Systematic review protocol for assessing central auditory functions of Alzheimer’s disease and its preclinical stages
Publisher: BMJ
Date: 06-2020
DOI: 10.1136/BMJOPEN-2019-033342
Abstract: A number of studies have reported an association between peripheral hearing impairment, central auditory processing and Alzheimer’s disease (AD) and its preclinical stages. Both peripheral hearing impairment and central auditory processing disorders are observed many years prior to the clinical manifestation of AD symptoms, hence, providing a long window of opportunity to investigate potential interventions against neurodegenerative processes. This paper outlines the protocol for a systematic review of studies examining the central auditory processing functions in AD and its preclinical stages, investigated through behavioural (clinical assessments that require active participation) central auditory processing tests. We will use the keywords and Medical Subject Heading terms to search the following electronic databases: MEDLINE, PsychINFO, PubMed, Scopus, EMBASE and CINAHL Plus. Studies including assessments of central auditory function in adults diagnosed with dementia, AD and its preclinical stages that were published before 8 May 2019 will be reviewed. This review protocol will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. Data analysis and search results will be reported in the full review. This manuscript has designed the protocols for a systematic review that will identify the behavioural clinical central auditory processing measures that are sensitive to the changes in auditory function in adults with AD and its preclinical stages. Such assessments may subsequently help to design studies to examine the potential impact of hearing and communication rehabilitation of in iduals at risk of AD. Ethical approval is not required as this manuscript only reports the protocols for conducting a systematic review as primary data will only be reviewed and not be collected. The results of this systematic review will be disseminated through publication and in scientific conferences. CRD42017078272.
Hearing loss and depression in older adults
Publisher: Oxford University Press (OUP)
Date: 05-03-2020
Abstract: Studies reporting an association between hearing loss and depression in older adults are conflicting and warrant a systematic review and meta-analysis of the evidence. A search of academic databases (e.g., MEDLINE) and gray literature (e.g., OpenGrey) identified relevant articles published up to July 17, 2018. Cross-sectional or cohort designs were included. Outcome effects were computed as odds ratios (ORs) and pooled using random-effects meta-analysis (PROSPERO: CRD42018084494). A total of 147,148 participants from 35 studies met inclusion criteria. Twenty-four studies were cross-sectional and 11 were cohort designs. Overall, hearing loss was associated with statistically significantly greater odds of depression in older adults (OR = 1.47, 95% confidence interval [CI] = 1.31−1.65). When studies were stratified by design, hearing loss was associated with greater odds of depression in cross-sectional studies (OR = 1.54, 95% CI = 1.31−1.80) and cohort studies (OR = 1.39, 95% CI = 1.16 − 1.67), and there was no difference between cross-sectional or cohort effect estimates (Q = 0.64, p = .42). There was no effect of moderator variables (i.e., hearing aid use) on the association between hearing loss and depression, but these findings must be interpreted with caution. There was no presence of publication bias but certainty in the estimation of the overall effect was classified as “low.” Older adults may experience increased odds of depression associated with hearing loss, and this association may not be influenced by study or participant characteristics.
Hearing and vision health for people with dementia in residential long term care: Knowledge, attitudes and practice in England, South Korea, India, Greece, Indonesia and Australia
Publisher: Wiley
Date: 05-05-2021
DOI: 10.1002/GPS.5563
Abstract: Up to 90% of people with dementia in long term care (LTC) have hearing and/or vision impairment. Hearing/vision difficulties are frequently under‐recognised or incompletely managed. The impacts of hearing/vision impairment include more rapid cognitive decline, behavioural disturbances, reduced quality of life, and greater care burden. This research investigated LTC staff knowledge, attitudes and practice regarding hearing/vision care needs for residents with dementia. A survey of staff in LTC facilities in England, South Korea, India, Greece, Indonesia and Australia. Respondents used a five‐point scale to indicate agreement or YES/NO response to questions regarding sensory‐cognitive care knowledge (what is known) attitudes (what is thought) practice (what is done). Respondents reported high awareness of hearing/vision care needs, although awareness of how to identify hearing/vison difficulties or refer for assessment was low. Most felt that residents were not able to use hearing/vision devices effectively due to poor fit, being poorly tolerated or lost or broken devices. A substantial minority of respondents reported low confidence in supporting use of assistive hearing/vision devices, with lack of training the main reason. Most staff did not undertake routine checking of hearing/vision devices, and it was rare for facilities to have designated staff responsible for sensory needs. Variation among countries was not significant after accounting for staff experience and having received dementia training. There is a need to improve sensory support for people with dementia in LTC facilities internationally. Practice guidelines and training to enhance sensory‐cognitive knowledge, attitudes and practice in professional care teams is called for.
The Peripheral Hearing and Central Auditory Processing Skills of Individuals With Subjective Memory Complaints
Publisher: Frontiers Media SA
Date: 21-08-2020
The link between hearing loss, dementia and mental health: A community conversation.
Publisher: Wiley
Date: 18-04-2020
DOI: 10.1111/AJAG.12719
Teleaudiology hearing aid fitting follow-up consultations for adults
Publisher: Informa UK Limited
Date: 23-09-2020
Impact of Cochlear Implantation on Cognitive Functions of Older Adults
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2017
DOI: 10.1097/MAO.0000000000001502
Abstract: A significant relationship between hearing loss and cognitive impairment has been previously reported. Overall, improvement in speech perception in quiet and quality of life has been observed after cochlear implantation. However, the impact of hearing loss treatment using cochlear implantation on cognitive functions is yet to be fully elucidated. To investigate the impact of cochlear implantation on cognitive and psychological functions of older adults. Prospective patient-control study. A total of 39 participants took part in the study: 23 cochlear implant (CI) candidates (M = 69.04 ± 12.35 yr) and 16 CI recipients (M = 61.75 ± 15.62 yr). All participants completed an assessment of hearing (pure-tone thresholds and speech perception in quiet), and a computerised, nonverbal test battery of cognitive function assessment, as well as a depression, anxiety, and stress scale. Independent-s le t test scores for the changes between 0 and 12 months revealed that CI recipients performed significantly better on measures of simple reaction time, cognitive flexibility, paired-associate learning, working memory, and strategy use ( p 0.05) compared with implant candidates. Compared with the candidates, recipients also showed significantly lower stress scores ( p 0.05) after 1 year use of a CI. Our results indicate that even in participants with a long duration, severe to profound hearing loss, cochlear implantation has some impact on improving a number of cognitive functions. This finding warrants future longitudinal investigations with a large s le size to examine if the observed cognitive enhancement benefits are sustainable.
An Opportunity for Constructing the Future of Data Sharing in Otolaryngology
Publisher: Springer Science and Business Media LLC
Date: 10-08-2023
Auditory-cognitive training for adult cochlear implant recipients: a study protocol for a randomised controlled trial
Publisher: Springer Science and Business Media LLC
Date: 12-11-2021
DOI: 10.1186/S13063-021-05714-7
Abstract: There is an urgent need to develop new therapies to improve cognitive function in adults following cochlear implant surgery. This study aims to determine if completing at-home computer-based brain training activities improve memory and thinking skills in adults following their first cochlear implant. This study will be conducted as a single-blind, head-to-head, randomised controlled trial (RCT). It will determine whether auditory training combined with adaptive computerised cognitive training will elicit greater improvement in cognition, sound and speech perception, mood, and quality of life outcomes in adult cochlear implant recipients, when compared to auditory training combined with non-adaptive (i.e. placebo) computerised cognitive training. Participants 18 years or older who meet the clinical criteria for a cochlear implant will be recruited into the study. The results of this trial will clarify whether the auditory training combined with cognitive training will improve cognition, sound and speech perception, mood, and quality of life outcomes in adult cochlear implant recipients. We anticipate that our findings will have implications for clinical practice in the treatment of adult cochlear implant recipients. Australian New Zealand Clinical Trials Registry ACTRN12619000609156 . Registered on April 23 2019.
IMPACT OF COCHLEAR IMPLANTATION ON COGNITIVE FUNCTIONS OF OLDER ADULTS
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2018
Self-reported cochlear implant management skills: development and validation of the self-administered Cochlear Implant Management Skills (CIMS-self) survey
Publisher: Wiley
Date: 10-08-2017
DOI: 10.1111/COA.12713
Abstract: A self-administered device management survey was developed and validated to investigate the ability of cochlear implant recipients to self-report physical handling and care for their hearing implant device(s) and to identify factors that may influence self-reported management skills. Survey development and validation. A prospective convenience cohort design study. Specialist hearing implant clinic. Forty-nine post-lingually hearing impaired, adult cochlear implant recipients, at least 12 months postoperative. Survey test-retest reliability, responsiveness, criterion validity and sensitivity and specificity compared to clinician evaluation of device management skills. Correlations between self-reported management skills and participant demographic, audiometric, cognitive function, clinical outcomes and device factors. The self-administered Cochlear Implant Management Skills survey was developed, demonstrating high test-retest reliability (ICC = 0.884, P < 0.001 CI 95%: 0.721-0.952), responsiveness to intervention (management skills training) [t(20) = -3.245, P = 0.004], criterion validity (ICC = 0.765, P < 0.001 CI 95%: 0.584-0.868) and sensitivity (0.89). No associations were found between self-reported management skills and participant factors. This study demonstrated that a self-report survey is an effective method for the evaluation of skills required for cochlear implant device management.
Is There an Association Between Untreated Hearing Loss and Psychosocial Outcomes?
Publisher: Frontiers Media SA
Date: 19-05-2022
DOI: 10.3389/FNAGI.2022.868673
Abstract: Age-related hearing loss is one of the leading causes of disability in older adults. This cross-sectional study investigated the association between untreated hearing loss, social (perception of quality and quantity of social network) and emotional loneliness (perception of limited emotional support), social isolation (size of the social network), social support (actual or perceived availability of resources from the social network) and psychological discomfort (depression, anxiety, and stress) in older adults. Cross-sectional study design. A total of 202 community derived s le of volunteers, age range 40–89 years, mean age (M) = 65.3 ± 11.0 years were recruited. Of these 115 were females ( M = 63.2 ± 12.0 years) and 87 were males ( M = 68.2 ± 8.9 years). All participants completed a hearing assessment, social interaction and support questionnaire and a social and emotional loneliness questionnaire. Hearing loss significantly contributed to both moderate [ P & 0.001, B (95% CI): 0.01 (0.99–1.02)] and intense levels [ P & 0.001, 0.02 (1.00–1.04)] of emotional loneliness. Depression was significantly associated with satisfaction with social support [ P & 0.001 −0.17 (−0.23 to −0.11), social interaction [ P = 0.01 −0.07 (−0.12 to −0.01)], and moderate [ P & 0.001 0.31 (1.22–1.53)] and intense [ P & 0.001 0.29 (1.20–1.50)] levels of emotional loneliness and intense levels of social loneliness [ P = 0.01 0.12 (1.05–1.21)]. Untreated hearing loss significantly increases the odds of being emotionally lonely. Depression significantly contributes to social and emotional loneliness, satisfaction with social support and social loneliness. Given the higher prevalence of loneliness and psychological discomfort and their associations with untreated hearing loss, hearing-impaired older adults are at significant risk of developing loneliness and psychological discomfort. Therefore, hearing health professionals should be aware of the psychosocial burden that may accompany hearing loss, in order to provide appropriate advice and support.
Hearing Loss and Depression in Older Adults: A Small Association
Publisher: Elsevier BV
Date: 2021
Speech-in-noise performance in objectively determined cochlear implant maps, including the effect of cognitive state
Publisher: Public Library of Science (PLoS)
Date: 14-06-2023
DOI: 10.1371/JOURNAL.PONE.0286986
Abstract: Cochlear Implant (CI) programming based on subjective psychophysical fine-tuning of loudness scaling involves active participation and cognitive skills and thus may not be appropriate for difficult-to-condition populations. The electrically evoked stapedial reflex threshold (eSRT) is an objective measure that is suggested to provide clinical benefit to CI programming. This study aimed to compare speech reception outcomes between subjective and eSRT objectively determined CI maps for adult MED-EL recipients. The effect of cognitive skills on these skills was further assessed. Twenty-seven post lingually hearing-impaired MED-EL CI recipients were recruited, 6 with mild cognitive impairment (MCI– 4 male, 79 years ± 5), 21 with normal cognitive function (5 male, 63 years ± 12). Two MAPs were generated: a subjective MAP and an objective MAP in which eSRTs determined maximum comfortable levels (M-Levels). Participants were randomly ided into two groups. Group A trialled the objective MAP for two weeks before returning for outcome assessment. During the following two weeks, Group A trialled the subjective MAP before returning for outcome assessment. Group B trialled MAPs in reverse. Outcome measures included the Hearing Implant Sound Quality Index (HISQUI), Consonant-Nucleus-Consonant (CNC) word test, and Bamford-Kowal-Bench Speech-in-Noise (BKB-SIN) test. eSRT based MAPS were obtained in 23 of the participants. A strong relationship was demonstrated between global charge between eSRT-based and psychophysical-based M-Levels (r = 0.89, p .001). The Montreal Cognitive Assessment for the Hearing Impaired (MoCA-HI) testing identified 6 CI recipients with MCI (MoCA-HI total score ≤23). The MCI group was older (63, 79 years), but were not otherwise different in sex, duration of hearing loss or duration of CI use. For all patients, no significant differences were found for sound quality or speech in quiet scores between eSRT-based and psychophysical-based MAPs. However, psychophysically determined MAPs showed significantly better speech-in-noise reception (6.74 vs 8.20-dB SNR, p = .34). MoCA-HI scores showed a significant, moderate negative correlation with BKB SIN for both MAP approaches (Kendall’s Tau B, p = .015 and p = .008), with no effect on the difference between MAP approaches. Results indicate eSRT-based methods provide poorer outcomes than psychophysical-based method. While speech-in-noise reception is correlated with MoCA-HI score, this affected both behaviourally and objectively determined MAPs. The results suggest fair confidence in the eSRT-based method as a guide for setting M-Level for difficult-to-condition CI populations in simple listening conditions.
Hearing loss and mental health issues in amateur and professional musicians
Publisher: SAGE Publications
Date: 29-03-2023
DOI: 10.1177/03057356231155970
Abstract: Musicians are at risk of developing music-induced hearing loss (MIHL) and also exhibit increased prevalence of depression, anxiety, and stress. However, the relationship between hearing loss and mental health issues in musicians has not yet been explored. This study conducted a cross-sectional analysis of 32 professional and 35 amateur musicians recruited from local bands and orchestras. KUDUwave software was used to obtain their overall hearing thresholds for both ears over three frequency ranges: 0.5 to 4, 6 to 8, and 9 to 16 kHz. Participants also completed a demographic questionnaire that contained questions related to musical exposure, type of music exposed, years of practice, and so on, and the DASS-21 questionnaire, which assesses the presence of depression, anxiety, and stress symptoms. Professional musicians had significantly greater music exposure compared with amateur musicians, but their hearing thresholds were not significantly different from amateur musicians in 0.5–4, 6–8, or 9–16 kHz frequency ranges. Professional musicians experienced greater symptoms of anxiety compared with amateur musicians, and this occurred independently of their hearing status. Further longitudinal studies are required to explore the causative factors resulting in increased mental health issues in professional musicians and what potential interventions may be implemented to address anxious symptomology in this population.
A prospective study evaluating cochlear implant management skills: development and validation of the Cochlear Implant Management Skills survey
Publisher: Wiley
Date: 07-01-2016
DOI: 10.1111/COA.12472
Abstract: To investigate the ability of cochlear implant (CI) recipients to physically handle and care for their hearing implant device(s) and to identify factors that may influence skills. To assess device management skills, a clinical survey was developed and validated on a clinical cohort of CI recipients. Survey development and validation. A prospective convenience cohort design study. Specialist hearing implant clinic. Forty-nine post-lingually deafened, adult CI recipients, at least 12 months postoperative. Survey test-retest reliability, interobserver reliability and responsiveness. Correlations between management skills and participant demographic, audiometric, clinical outcomes and device factors. The Cochlear Implant Management Skills survey was developed, demonstrating high test-retest reliability (0.878), interobserver reliability (0.972) and responsiveness to intervention (skills training) [t(20) = -3.913, P = 0.001]. Cochlear Implant Management Skills survey scores range from 54.69% to 100% (mean: 83.45%, sd: 12.47). No associations were found between handling skills and participant factors. This is the first study to demonstrate a range in cochlear implant device handling skills in CI recipients and offers clinicians and researchers a tool to systematically and objectively identify shortcomings in CI recipients' device handling skills.
Association between hearing loss and frailty: a systematic review and meta-analysis
Publisher: Springer Science and Business Media LLC
Date: 25-05-2021
DOI: 10.1186/S12877-021-02274-Y
Abstract: Frailty is associated with poor health outcomes in later life. Recent studies suggested that hearing loss may be a potentially modifiable risk factor associated with frailty. This systematic review and meta-analysis aimed to investigate the association between hearing loss and frailty in observational studies of adults aged 50 years or over. We included observational studies with participants ≥ 50 years old that have clear descriptions of hearing and frailty measurement methods. Meta-analyses were conducted using measurement of risk and 95 % confidence interval of each in idual study. Quality assessment, risk of bias, heterogeneity and sensitivity analyses were also conducted. Our study followed PRISMA guidelines. Our search identified 4508 manuscripts published in English between 1 and 2000 and 9 February 2021. Sixteen articles reported acceptable measurements of both hearing loss and frailty. Two papers were not suitable for meta-analysis. Twelve sets of cross-sectional data involving 12,313 participants, and three sets of longitudinal data involving 3042 participants were used in the meta-analysis. Hearing loss was associated with an 87 % increase in the risk of frailty among cross-sectional studies (risk ratio [RR] 1.87 95 %CI 1.63–2.13) and 56 % among longitudinal studies (RR 1.56 95 %CI 1.29–1.88). There was considerable heterogeneity among studies, but their quality rating, s le size or approach used to assess hearing loss did not change the results substantially. The findings of this systematic review and meta-analysis of observational studies suggest that hearing loss increases the risk of frailty in later life. Whether this relationship is causal remains to be determined.
Validation of remote mapping of cochlear implants
Publisher: SAGE Publications
Date: 27-03-2014
Abstract: Recipients of cochlear implants need to attend regular mapping sessions to adjust their speech processors. We developed a PC-based system for remote mapping, which employed voice, video and text communication. Eleven implant recipients had their implant electrodes programmed (mapped) both by conventional methods and remotely. Speech tests, conducted by a family member or research assistant, were used to test the outcome of the programming during the remote consultation. The recipient and audiologist were surveyed regarding aspects of the teleconsultation. There were no significant differences between conventionally and remotely programmed electrode settings. The speech test results were perfect in most cases. The average time to complete the conventional mapping session was 37 min and the average time for the remote mapping session was 42 min ( P = 0.034). Recipients and the audiologist reported favourably on most aspects of the consultations. Lack of synchronisation between voice and video was the most common problem, which disrupted communication. The assistant was important to overcome this problem. All but one participant indicated they would be willing to use tele-mapping in the future. Remote programming of cochlear implants can be conducted reliably with relatively simple equipment, potentially in the homes of remotely located patients assisted by a family member.
Teleaudiology Services for Rehabilitation With Hearing Aids in Adults: A Systematic Review
Publisher: American Speech Language Hearing Association
Date: 13-07-2018
DOI: 10.1044/2018_JSLHR-H-16-0397
Abstract: This review examined (a) the current evidence from studies on teleaudiology applications for rehabilitation of adults with hearing impairment with hearing aids and (b) whether it is sufficient to support the translation into routine clinical practice. A search strategy and eligibility criteria were utilized to include articles specifically related to hearing aid fitting and follow-up procedures that are involved in consultations for the rehabilitation of adults, where the service was provided by the clinician by teleaudiology. A search using key words and Medical Subject Headings (MeSH) was conducted on the main electronic databases that index health-related studies. The included studies were assessed using validated evaluation tools for methodological quality, level of evidence, and grade recommendations for application into practice. Fourteen studies were identified as being within the scope of this review. The evaluation tools showed that none of these studies demonstrated either a strong methodological quality or high level of evidence. Analysis of evidence identified 19 activities, which were classified into service outcomes categories of feasibility, barriers, efficiency, quality, and effectiveness. Recommendations could be made regarding the (a) feasibility, (b) barriers, and (c) efficiency of teleaudiology for the rehabilitation of hearing loss with hearing aids. This review provides up-to-date evidence for teleaudiology hearing aid services in new and experienced hearing aid users in different practice settings. Findings direct future research priorities to strengthen evidence-based practice. There is a need for further studies of many aspects of teleaudiology services for rehabilitation with hearing aids to support their implementation into clinical practice. 0.23641/asha.6534473
Hearing impairment and frailty in later life: The Health in Men Study (HIMS)
Publisher: Elsevier BV
Date: 02-2022
DOI: 10.1016/J.MATURITAS.2021.10.008
Abstract: To determine if hearing loss is associated with increased risk of frailty in later life. Cross-sectional study of a community s le of 4,004 men aged 70 years and above living in the metropolitan region of Perth, Western Australia. Data were retrieved from the Health in Men Study (HIMS) and the Western Australian Data Linkage System (WADLS). Frailty was assessed using the FRAIL scale and the Frailty Index. Hearing loss was defined by self-report or by diagnosis recorded in the WADLS. We also collected demographic, lifestyle and social support information. Frailty was assessed using the FRAIL scale and the Frailty Index. The prevalence of frailty in the s le population was 16.1% and 25.4% when assessed using the FRAIL scale and the Frailty Index respectively. After adjusting for participant demographic, lifestyle and social factors, hearing loss was significantly associated with the prevalence of frailty when diagnosed by either measure (FRAIL scale: odds ratio [OR] 1.59, 95 CI% 1.32 to 1.91 Frailty Index: OR 1.76, 95 CI% 1.50 to 2.05). The proportion of men with hearing loss increased with increasing severity of frailty. Hearing loss is associated with increased prevalence of frailty in older men when assessed using the FRAIL scale and the Frailty Index. Future longitudinal studies using objective measures of hearing will be helpful in determining if this association is likely to be causal.
Hearing aids to support cognitive functions of older adults at risk of dementia: the HearCog trial- clinical protocols
Publisher: Springer Science and Business Media LLC
Date: 26-11-2020
DOI: 10.1186/S12877-020-01912-1
Abstract: Globally, about 50 million people were living with dementia in 2015, with this number projected to triple by 2050. With no cure or effective treatment currently insight, it is vital that factors are identified which will help prevent or delay both age-related and pathological cognitive decline and dementia. Observational data have suggested that hearing loss is a potentially modifiable risk factor for dementia, but no conclusive evidence from randomised controlled trials is currently available. The HearCog trial is a 24-month, randomised, controlled clinical trial aimed at determining whether a hearing loss intervention can delay or arrest the cognitive decline. We will randomise 180 older adults with hearing loss and mild cognitive impairment to a hearing aid or control group to determine if the fitting of hearing aids decreases the 12-month rate of cognitive decline compared with the control group. In addition, we will also determine if the expected clinical gains achieved after 12 months can be sustained over an additional 12 months and if losses experienced through the non-correction of hearing loss can be reversed with the fitting of hearing aids after 12 months. The trial will also explore the cost-effectiveness of the intervention compared to the control arm and the impact of hearing aids on anxiety, depression, physical health and quality of life. The results of this trial will clarify whether the systematic correction of hearing loss benefits cognition in older adults at risk of cognitive decline. We anticipate that our findings will have implications for clinical practice and health policy development. Australian and New Zealand Clinical Trials Registry ( ANZCTR: 12618001278224 ), registered on 30.07.2018.
Central Auditory Functions of Alzheimer’s Disease and Its Preclinical Stages: A Systematic Review and Meta-Analysis
Publisher: MDPI AG
Date: 16-03-2022
Abstract: In 2020, 55 million people worldwide were living with dementia, and this number is projected to reach 139 million in 2050. However, approximately 75% of people living with dementia have not received a formal diagnosis. Hence, they do not have access to treatment and care. Without effective treatment in the foreseeable future, it is essential to focus on modifiable risk factors and early intervention. Central auditory processing is impaired in people diagnosed with Alzheimer’s disease (AD) and its preclinical stages and may manifest many years before clinical diagnosis. This study systematically reviewed central auditory processing function in AD and its preclinical stages using behavioural central auditory processing tests. Eleven studies met the full inclusion criteria, and seven were included in the meta-analyses. The results revealed that those with mild cognitive impairment perform significantly worse than healthy controls within channel adaptive tests of temporal response (ATTR), time-compressed speech test (TCS), Dichotic Digits Test (DDT), Dichotic Sentence Identification (DSI), Speech in Noise (SPIN), and Synthetic Sentence Identification-Ipsilateral Competing Message (SSI-ICM) central auditory processing tests. In addition, this analysis indicates that participants with AD performed significantly worse than healthy controls in DDT, DSI, and SSI-ICM tasks. Clinical implications are discussed in detail.
Hearing loss and cognitive decline in Singapore: status quo of an island nation
Publisher: Cambridge University Press (CUP)
Date: 05-2016
Hearing Impairment and Incident Frailty in Later Life
Publisher: Springer Science and Business Media LLC
Date: 20-03-2023
Systematic Review and Meta-analysis of STM and WM in Long-Term CI Users
Publisher: Springer Science and Business Media LLC
Date: 19-02-2022
Speech perception scores in cochlear implant recipients
Publisher: Informa UK Limited
Date: 05-02-2016
DOI: 10.1080/14670100.2015.1114220
Abstract: To evaluate the clinical utility of the City University of New York sentence test in a cohort of post-lingually deafened cochlear implants recipients over time. 117 post-lingually deafened, Australian English-speaking CI recipients aged between 23 and 98 years (M = 66 years SD = 15.09) were recruited. CUNY sentence test scores in quiet were collated and analysed at two cut-offs, 95% and 100%, as ceiling scores. CUNY sentence scores ranged from 4% to 100% (M = 86.75 SD = 20.65), with 38.8% of participants scoring 95% and 16.5% of participants reaching the 100% scores. The percentage of participants reaching the 95% and 100% ceiling scores increased over time (6 and 12 months post-implantation). The distribution of all post-operative CUNY test scores skewed to the right with 82% of test scores reaching above 90%. This study demonstrates that the CUNY test cannot be used as a valid tool to measure the speech perception skills of post-lingually deafened CI recipients over time. This may be overcome by using adaptive test protocols or linguistically, cognitively or contextually demanding test materials. The high percentage of CI recipients achieving ceiling scores for the CUNY sentence test in quiet at 3 months post-implantation, questions the validity of using CUNY in CI assessment test battery and limits its application for use in longitudinal studies evaluating CI outcomes. Further studies are required to examine different methods to overcome this problem.
The effect of hearing loss configuration on cochlear implantation uptake rates: an Australian experience
Publisher: Informa UK Limited
Date: 04-06-2020
Association between speech and high-frequency hearing loss and depression, anxiety and stress in older adults
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.MATURITAS.2018.02.002
Abstract: Age-related hearing loss (ARHL) and depression are considered leading causes of disability in older adults. This cross-sectional study investigated the association between the severity of speech and high-frequency ARHL and depression, anxiety and stress in older adults. Cross-sectional study of a community-derived s le of adult volunteers. A hearing assessment was completed by 151 participants (73 males and 78 females M = 64.44 ± 10.77 years). Based on their better-ear speech (0.5, 1, 2, & 4 kHz) and high-frequency (6 & 8 kHz) hearing thresholds, they were ided three groups: those with normal hearing those with mild to moderate hearing loss and those with moderately severe to profound hearing loss. All participants also completed the Depression, Anxiety and Stress Scale (DASS-21). A binomial logistic regression analysis revealed that the respective odds ratios (ORs) (95% confidence interval) of clinically significant depression, anxiety and stress for participants with a moderately severe to profound hearing loss across the speech frequency range were: 27.51 (3.25, 232.95), 5.89 (1.95, 17.73) and 5.64 (1.55, 20.48). Similarly, the respective ORs of clinically significant depression, anxiety and stress were 6.54 (0.75, 57.02), 6.21 (1.52, 25.33) and 5.32 (1.02, 27.75) for participants with moderately severe to profound hearing loss across high frequencies. The non-parametric Cuzik test revealed a statistically significant positive (p < .05) trend of association between both better-ear speech and high-frequency hearing loss and DASS scores. The observed graded associations suggest that hearing loss is a causative factor for clinically significant depression, anxiety and stress symptoms.
Selective attentional processes in cochlear implant recipients: Measurements of the attentional filter
Publisher: Acoustical Society of America (ASA)
Date: 12-2016
DOI: 10.1121/1.4968783
Abstract: In normal hearing subjects, detection of near-threshold tones in noise is influenced by signal certainty. Thus, tones that are presented more frequently than others, and/or are preceded by a clearly audible cue tone of the same frequency (target tones) are detected better than other tones (probe tones). This auditory attentional filter was examined in six cochlear implant (CI) recipients, using acoustic stimuli and direct programmed electrode stimulation. Three of the subjects showed no evidence of an attentional filter. Three subjects showed a relatively higher detection rate of the target frequency or electrode stimulated during the attentional task, and in two of these subjects the target benefit was influenced by stimulus certainty. The absence of an attentional filter in some CI recipients is consistent with suggestions that the attentional filter may be generated by efferent modulation of outer hair cells, which would presumably be absent in CI recipients, however, the presence of some frequency-selective attentional effects and a near-normal attentional filter in two CI subjects imply that central processes can modulate signal detection in CI recipients according to stimulus certainty. Such central processes might serve as a neural substrate to improve signal detection in CI recipients.
Auditory-Cognitive Training For Adult Cochlear Implant Recipients: A Study Protocol for a Randomised Controlled Trial
Publisher: Research Square Platform LLC
Date: 28-06-2021
DOI: 10.21203/RS.3.RS-639855/V1
Abstract: Background: There is an urgent need to develop new therapies to improve cognitive function in adults following cochlear implant surgery. This study aims to determine if completing at-home computer-based brain training activities improve memory and thinking skills in adults following their first cochlear implant. Methods: This study will be conducted as a single-blind, head-to-head, randomised controlled trial (RCT). It will determine whether auditory training combined with adaptive computerised cognitive training will elicit greater improvement in cognition, sound and speech perception, mood, and quality of life outcomes in adult cochlear implant recipients, when compared to auditory training combined with non-adaptive (i.e., placebo) computerised cognitive training. Participants 18 years or older who meet the clinical criteria for a cochlear implant will be recruited into the study. Results: The results of this trial will clarify whether the auditory training combined with cognitive training will improve cognition, sound and speech perception, mood, and quality of life outcomes in adult cochlear implant recipients. Discussion: We anticipate that our findings will have implications for clinical practice in the treatment of adult cochlear implant recipients. Trial registration: ANZ clinical trial registration: ACTRN12619000609156
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