Measuring Meaningful Outcomes for Adults with Cochlear Implants across the Lifespan
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PROJECT SUMMARY Hearing loss (HL) is the most common sensory disorder in the U.S., affecting over half of adults over age 65. Nearly a quarter of those have HL severe enough to benefit from a surgically placed cochlear implant (CI). Hearing loss contributes to poorer communication abilities and is associated with cognitive decline, social withdrawal, and reduced quality of life (QoL). While treatment with a CI may help mitigate these negative impacts, speech communication outcomes remain highly variable. Additionally, up to 42% of CI recipients report decisional regret in pursuing implantation, with older adults demonstrating poorer outcomes and reporting higher decision regret. Nonetheless, the effects of aging on CI outcomes remain poorly understood. Additionally, current clinical measures of speech perception used to evaluate CI outcomes fail to capture the real-world lived experiences of CI recipients. As a result, we lack meaningful assessment tools to identify and rehabilitate individuals who struggle to communicate in the real world. Thus, a significant gap in knowledge remains regarding the impacts of CIs on meaningful outcomes across the adult lifespan, how needs differ across ages, and the mechanisms underlying age-related differences. This project will characterize age-specific communication and psychosocial outcomes through carrying out three Specific Aims. Aim 1 will characterize age-related differences using a new core CI outcome set and a battery of auditory and cognitive tests with quantitative methods. Aim 2 will identify the shared and unique communicative and psychosocial needs across age groups using qualitative approaches. Aim 3 will integrate quantitative and qualitative findings to identify age- specific outcome priorities. Our central hypothesis is that CI users will demonstrate age-specific differences in communication and psychosocial functions as well as distinct needs. Findings will lay the foundation for development of an ecologically meaningful toolbox of CI outcome measures relevant for developing individual profiles of needs and abilities of adults with hearing loss across the lifespan.
