This project examines how to improve speech understanding with cochlear implants (CIs), particularly for older CI recipients. While older individuals benefit from CI technology, performance is poorer than that of younger implanted adults for difficult listening tasks. The mechanisms that contribute to this variability are not well-understood. The current project examines how differences in brain structure and function may contribute to success with a cochlear implant. To compare, we will also be examining how older patients without cochlear implants understand speech in difficult listening situations.

Patients with chronic or episodic recurrent dizziness will track their vestibular symptoms with every episode in the iPhone application, Vertige. They will track their symptoms at the conclusion of every episode for a total of six (6) months. The app has a geolocation software that will pair environmental data (barometric pressure, temperature, humidity, etc.) with symptoms. We will then analyze the data to evaluate for associations.

Patient-reported outcome measures (PROMs) are crucial for understanding the impact of cochlear implants (CIs) on real-world functional abilities and quality of life (QOL) and for monitoring changes over time. However, CI clinical outcome measures traditionally focus solely on CI users' speech recognition ability to evaluate treatment success, which limits our understanding of CI's effects on patients' social isolation, emotional impact, and mental and listening effort related to severe hearing loss. Moreover, patient's speech recognition scores demonstrate low correlations with CI users' real-world communication experiences and QOL. Therefore, there is a critical gap in the measures commonly used to quantify patient outcomes after CI activation. To address this gap, we developed the Cochlear Implant Quality of Life (CIQOL)-35 Profile instrument, which provides a comprehensive, patient-centered assessment of CI-related functional abilities and QOL. However, difficultly in interpreting an individual patient's PROM score is a major barrier for PROM implementation and applications to clinical care. Therefore, additional work is critical for clinicians to appropriately interpret CIQOL-35 Profile scores for individual patients and apply those results to inform intervention decisions and monitor patient progress. In the current study we will longitudinally assess CI users CIQOL scores to help identify CI users with lower functional abilities who may benefit from increased support and allow clinicians to better track functional improvement after implantation for individual patients. This work will inform patient discussions regarding expected outcomes and timeframe for improvement.

Older adults typically have trouble identifying the speech they hear, especially in noisy environments. Fortunately, compared to younger adults, older adults are better able to compensate for difficulties identifying the speech they hear by recruiting the visual system. However, the extent to which older adults can benefit from visual input, and how this influence relates to age-related changes in brain structure and function, have not been thoroughly investigated. The general purpose of this study is to determine how age-related changes in brain structure and function affect how well people hear and see. This study seeks participants with normal hearing to mild hearing loss, who also have normal or corrected-to-normal vision.