The utility of the cognitive Mini-Mental State Examination and the Stroop Color and Word Test in explaining variations in speech perception outcomes among adult cochlear implant users: A pilot study

To explore the potential of the internationally-renowned ‘Mini-Mental State Examination’ (MMSE) cognitive measure to explain variability in cochlear implant (CI) recipients’ speech recognition outcomes. The Stroop Color-Word Test (SCWT) was also employed as a measure of cognitive inhibition, an ability essential for focusing on target speech whilst ignoring background noise. The authors hypothesize that MMSE and SCWT scores correlate with CI users’ performance on established speech recognition tests.
Cognitive screening was assessed by the MMSE and SCWT in adult CI users one year postoperatively. In addition, speech recognition was assessed using word and sentence lists, in both quiet and noise. Study sample: 28 participants, postlingually deafened adult CI users, median age 75 years.
Total MMSE scores correlated significantly with sentence recognition in noise (r = 0.621, P = .004), although no correlation was identified in quiet. Furthermore, the SCWT incongruent condition correlated significantly with CI users’ speech recognition in noise (r = −0.644, P = .007).
Global cognition (as assessed using the MMSE), and inhibition-concentration (as assessed using the SCWT), seem to be important factors in influencing CI recipients’ speech intelligibility in noise. This pilot study recommends a larger-scale study; given the global popularity of the MMSE and SCWT as quick cognitive screening tests, they may be useful in CI clinics when speech perception outcomes are unexpectedly poor for older adults and when questions of cognition arise.
These standardized cognitive measures may prove helpful in counseling patients and families when coming to terms with CI outcomes and optimizing multidisciplinary rehabilitation strategies.