Cochlear implantation outcomes in older adults

Objective: More than 40% of the population above 65 years of age suffers from hearing impairment and approximately 1% has a severe to profound loss, which cannot benefit from hearing aids. There is strong evidence that hearing loss in older adults is associated with both cognitive impairment and aging. Cochlear implantation improves auditory function and speech perception. The aim of this paper was to analyse outcomes and complications of cochlear implantation in elderly patients. Methods: We used a retrospective observational study on 30 hearing impaired patients over 65 years of age, unilaterally implanted for severe to profound bilateral sensorineural hearing loss. The results were statistically evaluated through the Student 's t-test for paired data. Results: Thirty patients (16 males and 14 females) between 65 and 79 years of age (median=70.5) underwent cochlear implantation in the last four years at our clinic. They were unilaterally implanted for profound hearing loss: the left side was implanted in 19 cases, the right side in 11 cases. Pre-operative pure tone average at 0.5, 1, 2, and 4 kHz improved from 111.8dB HL (+/- 17.8) without hearing aids to 42.6dB HL (+/- 10) with the cochlear implant during the post-operative period of follow-up; speech recognition threshold mean improved from 90dB SPL to 65dB SPL. No major complications were noticed during post-operative follow-ups. Discussion: Cochlear implantation is a safe procedure even among elderly patients who can significantly benefi t from hearing threshold (p<0.001) and speech perception (p<0.01) improvements. Familial and professional supports are essential, as well as specific conditions, such as long time deprivation, entity and type of hearing loss, cognitive status, depression and anxiety, which can greatly influence the results of auditory rehabilitation and its perceived benefits. Conclusion: Cochlear implantation should be considered a safe and effective treatment of hearing loss even in older adults.