Audiovisual Speech Recognition in Adult Cochlear Implant Candidates: Relations with Cognitive-Linguistic Abilities

To examine audiovisual (AV) sentence recognition performance in adults with moderate-to-profound sensorineural hearing loss who are cochlear implant (CI) candidates, and to identify the demographic, audiologic, and cognitive-linguistic abilities that explain individual differences in AV performance.

Cross-sectional observational study.

Tertiary referral center.

Twenty-four postlingually deafened adults (mean age = 70.3 years, SD = 11.2) meeting clinical CI candidacy criteria in both ears, with no known history of cognitive or neurological disorders.

Participants completed the Multimodal Lexical Sentence Test (MLST) for Adults for AV sentence recognition and a battery of cognitive-linguistic tasks measuring short-term memory, working memory, inhibition-concentration, nonverbal reasoning, and speed of lexical/phonological access.

AV sentence recognition accuracy on the MLST.

MLST performance varied broadly across participants (range = 11%-98%, mean = 67.6, SD = 29.7) and was strongly correlated with auditory-only sentence recognition abilities (rho = 0.85, P < 0.001). Otherwise, AV sentence recognition was not significantly correlated with demographic or additional audiological variables. Short-term memory capacity, measured using visual Forward Digit Span, significantly explained MLST performance (partial rho = 0.44, P = 0.02), after controlling for auditory-only sentence recognition in quiet. Other cognitive-linguistic measures were not significantly associated with MLST scores.

AV sentence recognition in adult CI candidates is partially explained by short-term memory capacity. Ecologically valid AV assessments may help identify cognitively mediated barriers to real-world communication that are not captured using conventional auditory-only speech recognition tests.