***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In the present study , the effects of hearing aid use by hearing-impaired older individuals on different aspects of cognitive function , such as memory , attention , executive functioning , and processing speed , were investigated . Fifty-six participants ( mean age = 72.5 ) who were fitted with hearing aids were compared with 46 control participants ( mean age = 74.5 ) with an equivalent hearing impairment , but who were not fitted with a hearing aid .  After a dual baseline measurement and fitting of the hearing aids , all participants were assessed again with neurocognitive tests after 12 months . While the participants with hearing aids had improved aided hearing thresholds , they did not demonstrate an improved performance on the cognitive tests compared to the controls . Thus improved hearing did not improve cognitive functioning . These findings may suggest that hearing aid use only restores impairments at the level of the sensory organ , but does not affect the central nervous system and , as a consequence , cognitive functioning OBJECTIVE To evaluate quality of life ( QoL ) and cognitive function in elderly patients with cochlear implants  relative to auditory improvement , using geriatric vali date d scales . STUDY DESIGN Prospect i ve observational study . SETTING A tertiary referral center for cochlear implantation ( CI )  and a geriatric center in Nancy , France . PATIENTS Sixteen consecutive patients were included , from 65 to 80 years old , with postlingual severe-to-profound deafness . MAIN OUTCOME MEASURES Evaluations were conducted before and at 6 and 12 months after cochlear implant surgery . A  monosyllabic word recognition test  was used to measure speech perception . QoL was evaluated by the World Health Organization Quality of Life Assessment for elderly people ; cognitive function was evaluated by the Mini-Mental State Examination ; depression was evaluated by the Hamilton Scale ; autonomy was evaluated by the Instrumental Activities of Daily Living . RESULTS Speech intelligibility evolved from 10 % before surgery to 63 % and 69 % at 6 and 12 months after cochlear implant activation , respectively . QoL showed significant improvement in sensory abilities . The Mini-Mental State Examination evaluations remained stable and executive functions tended to improve . Autonomy improved significantly . CONCLUSION Cochlear implantation improves autonomy and the QoL in the elderly . Cognitive functions are not influenced by surgery , but executive functions appear to benefit from implantation . Age should not be a limiting factor , and cochlear implantation can be proposed as an efficient treatment for severe-to-profound hearing loss in the elderly IMPORTANCE The association between hearing impairment and cognitive decline has been established ; however , the effect of cochlear implantation on cognition in profoundly deaf elderly patients is not known . OBJECTIVE To analyze the relationship between cognitive function and hearing restoration with a  cochlear implant in elderly patients . DESIGN , SETTING , AND PARTICIPANTS Prospect i ve longitudinal study performed in 10 tertiary referral centers between September 1 , 2006 , and June 30 , 2009 . The participants included 94 patients aged 65 to 85 years with profound , postlingual hearing loss who were evaluated before , 6 months after , and 12 months after cochlear implantation .  INTERVENTIONS Cochlear implantation and aural rehabilitation program . MAIN OUTCOMES AND MEASURES Speech perception was measured using disyllabic word recognition tests in quiet and in noise setting s. Cognitive function was assessed using a battery of 6 tests evaluating attention , memory , orientation , executive function , mental flexibility , and fluency ( Mini-Mental State Examination , 5-word test , clock-drawing test , verbal fluency test , d2 test of attention , and Trail Making test parts A and B ) . Quality of life and depression were evaluated using the Nijmegen Cochlear Implant Question naire and the Geriatric Depression Scale-4 . RESULTS Cochlear implantation led to improvements in speech perception in quiet and in noise ( at 6 months : in quiet , 42 % score increase [ 95 % CI , 35%-49 % ; P < .001 ] ; in noise , at signal to noise ratio [ SNR ] + 15 dB , 44 % [ 95 % CI , 36%-52 % , P < .001 ] , at SNR + 10 dB , 37 % [ 95 % CI 30%-44 % ; P < .001 ] , and at SNR + 5 dB , 27 % [ 95 % CI , 20%-33 % ; P < .001 ] ) , quality of life , and Geriatric Depression Scale-4 scores ( 76 % of patients gave responses indicating no depression at 12 months after implantation vs 59 % before implantation ; P = .02 ) . Before cochlear implantation , 44 % of the patients ( 40 of 91 ) had abnormal scores on 2 or 3 of 6 cognition tests . One year after implant , 81 % of the subgroup ( 30 of 37 ) showed improved global cognitive function ( no or 1 abnormal test score ) . Improved mean scores in all cognitive domains were observed as early as 6 months after cochlear implantation . Cognitive performance remained stable in the remaining 19 % of the participants ( 7 of 37 ) . Among patients with the best cognitive performance before implantation ( ie , no or 1 abnormal cognitive test score ) , 24 % ( 12 of 50 ) displayed a slight decline in cognitive performance . Multivariate analysis to examine the association between cognitive abilities before implantation and the variability in cochlear implant outcomes demonstrated a significant effect only between long-term memory and speech perception in noise at 12 months ( SNR + 15 dB , P = .01 ; SNR + 10 dB , P < .001 ; and SNR + 5 dB , P = .02 ) . CONCLUSIONS AND RELEVANCE Rehabilitation of hearing communication through cochlear implantation in elderly patients results in improvements in speech perception and cognitive abilities and positively influences their social activity and quality of life . Further research is needed to assess the long-term effect of cochlear implantation on cognitive decline Purpose Postoperative cognitive dysfunction ( PCD ) is a subtle , prolonged deterioration in cognition after surgery . This complication has been frequently investigated , mainly after major ( cardiac ) surgery . However , the incidence after cochlear implantation is unknown . Therefore , the aim of the study was to investigate the incidence and possible risk factors of PCD in severely hearing-impaired older adults after cochlear implantation .  Methods In a prospect i ve cohort study , 26 older participants ( age : M = 70 , SD = 8 years ) , scheduled for cochlear implantation  , were assessed prior to and 1 week after implantation by means of the Montreal Cognitive Assessment ( MoCA )  . The incidence of PCD was calculated . In addition , the following possible risk factors were recorded : age , sex , education , duration of hearing impairment , preoperative signs of depression and anxiety , duration of anesthesia , anesthetic and surgical events and postoperative complications . Results The incidence of PCD was 11.5 % , defined by a Z score of change in MoCA scores ≥ 1.96 ( i.e. , a decrease of ≥ 4 points ) . The incidence of PCD was corrected for practice effects by incorporating data from a reference group . Besides an effect of age on the postoperative cognitive performance , no significant risk factors were identified . Conclusions The incidence of PCD  after cochlear implantation is lower than after major surgeries , but higher than after other minor surgeries . Routine cognitive screening before and after cochlear implantation is recommended to identify patients with PCD and to provide additional care for these patients With the physical , emotional and cognitive effects of senility , elderly people , especially those with impaired hearing , need rehabilitation for improving their life conditions . Hearing aids are frequently used to improve their daily life communications and activities . The aim of this study was to report the cognitive and psychological benefits of using hearing aids by the elderly people , over the age of 65 . This was a prospect i ve , single-arm interventional study in 34 elderly subjects with hearing impairment who answered the geriatric depression scale-short form ( GDS ) question naire and the  mini mental state examination  ( MMSE ) test , prior to , and 3 months following the use of hearing aid  , after obtaining the patients ' consent to participate in study . Patients with evidence of focal neurological loss with clinical examination , a confusional state , sudden hear loss and severe tinnitus were not included in the study .  Scores of the effects of hearing aids on mood and cognitive functions were compared for each subject , before and after , and between males and females . After 3 months of using a hearing aid , all patients showed a significant improvement of the psychosocial and cognitive conditions , and all of them showed betterment of their problems , i.e. , the social communication and exchanging information . In conclusion , for the elderly people with the effects of hearing aids in presbycusis and due to the significant improvement in psychological state and mental functions , using and being adaptable to hearing aids is a good solution OBJECTIVE To determine whether hearing loss is associated with incident all-cause dementia and Alzheimer disease ( AD ) . DESIGN Prospect i ve study of 639 individuals who underwent audiometric testing and were dementia free in 1990 to 1994 . Hearing loss was defined by a pure-tone average of hearing thresholds at 0.5 , 1 , 2 , and 4 kHz in the better-hearing ear ( normal , < 25 dB [ n = 455 ] ; mild loss , 25 - 40 dB [ n = 125 ] ; moderate loss , 41 - 70 dB [ n = 53 ] ; and severe loss , > 70 dB [ n = 6 ] ) . Diagnosis of incident dementia was made by consensus diagnostic conference . Cox proportional hazards models were used to model time to incident dementia according to severity of hearing loss and were adjusted for age , sex , race , education , diabetes mellitus , smoking , and hypertension . SETTING Baltimore Longitudinal Study of Aging . PARTICIPANTS Six hundred thirty-nine individuals aged 36 to 90 years . MAIN OUTCOME MEASURE Incident cases of all-cause dementia and AD until May 31 , 2008 . RESULTS During a median follow-up of 11.9 years , 58 cases of incident all-cause dementia were diagnosed , of which 37 cases were AD . The risk of incident all-cause dementia increased log linearly with the severity of baseline hearing loss ( 1.27 per 10-dB loss ; 95 % confidence interval , 1.06 - 1.50 ) . Compared with normal hearing , the hazard ratio ( 95 % confidence interval ) for incident all-cause dementia was 1.89 ( 1.00 - 3.58 ) for mild hearing loss , 3.00 ( 1.43 - 6.30 ) for moderate hearing loss , and 4.94 ( 1.09 - 22.40 ) for severe hearing loss . The risk of incident AD also increased with baseline hearing loss ( 1.20 per 10 dB of hearing loss ) but with a wider confidence interval ( 0.94 - 1.53 ) . CONCLUSIONS Hearing loss is independently associated with incident all-cause dementia . Whether hearing loss is a marker for early-stage dementia or is actually a modifiable risk factor for dementia deserves further study Background : Currently , an independent relationship between hearing loss and cognitive decline in older adults is suggested by large prospect i ve studies . In general , cochlear implants improve hearing and the quality of life in severely to profoundly hearing impaired older persons . However , little is known about the effects of cochlear implantation on the cognitive evolution in this population . Aim of the study : The primary goal of this prospect i ve , longitudinal cohort study is to explore the cognitive profile of severely to profoundly postlingually hearing impaired subjects before and after cochlear implantation . In addition , the current study aims to investigate the relationship between the cognitive function , audiometric performances , quality of life , and self-reliance in these patients . Methods : Twenty-five patients aged 55 or older , scheduled for cochlear implantation , will be enrolled in the study . They will be examined prior to implantation , at 6 and 12 months after implantation and annually thereafter . The test battery consists of ( 1 ) a  cognitive examination  , using the Repeatable Battery for the Assessment of Neuropsychological Status adapted for Hearing impaired persons ( RBANS-H ) , ( 2 ) an  audiological examination  , including  unaided and aided pure tone audiometry , speech audiometry in quiet and speech audiometry in noise  , ( 3 ) the administration of four question naires evaluating quality of life and subjective hearing benefit and ( 4 ) a  semi-structured interview  about the self-reliance of the participant . Discussion : Up until now only one study has been conducted on this topic , focusing on the short-term effects of cochlear implantation on cognition in older adults . The present study is the first study to apply a comprehensive neuropsychological assessment adapted for severely to profoundly hearing impaired subjects in order to investigate the cognitive capabilities before and after cochlear implantation . Trial registration : The present protocol is retrospectively registered at Clinical Trials ( Clinical Trials.gov ) on June 9th , 2016 . The first participant was enrolled on June 22nd , 2015 . The protocol identifier is NCT02794350 Objective The aim of this case series was to assess the 
    Output:
    
However , they do not provide conclusive evidence of improved cognitive outcomes after cochlear implantation in older adults .