Cochlear Implants Benefit Adults Over 80, Study Shows

A recent study conducted by researchers at Washington University in St. Louis and Northwestern Medicine provides compelling evidence that cochlear implantation significantly improves hearing outcomes in older adults, including those in their 90s. The study, published in the journal Otology & Neurotology, is one of the largest analyses to date of cochlear implant outcomes in patients aged 80 and older.

The research team led by Dr. Kevin Y. Zhan analyzed data from 221 patients with bilateral sensorineural hearing loss who received cochlear implants. This included 171 patients in their 80s and 50 patients aged 90 or older. The findings challenge concerns that advanced age might limit the benefits of cochlear implantation.

"Cochlear implant speech recognition in both the 80-89 and 90+ age groups significantly improved from preoperative scores," the researchers reported. "No major speech recognition differences were identified between age groups."

Key findings from the study include:

• Both age groups showed substantial improvements in speech recognition tests one year after implantation

• Average word recognition scores improved to approximately 50% in both age groups, up from about 18% before implantation

• Speech recognition in quiet environments improved to around 50-54%, up from 19% preoperatively

• Patients used their devices consistently, with average daily use exceeding 11 hours in both age groups

• Initial balance symptoms (reported by about 23% of patients) decreased significantly over time, with only 7.5% reporting persistent symptoms after one year

Importantly, the researchers found that age at implantation, cognitive screening results, and presence of other health conditions did not negatively impact speech perception outcomes. This suggests that candidacy for cochlear implants should not be restricted based solely on age or cognitive status.

The study noted that approximately 60% of participants had abnormal preoperative cognitive screening results. However, this did not predict poorer outcomes after implantation, challenging assumptions that cognitive status should be a limiting factor in cochlear implant candidacy.

"Age at implantation, abnormal cognitive screening, and comorbidity status did not influence speech perception, which suggests that candidacy in older adult CI patients should not be withheld strictly due to these parameters," the authors concluded.

This research comes at a critical time as the American population ages, with a projected doubling of those over 65 by 2050. With expanded Medicare criteria for cochlear implant candidacy and evidence supporting successful outcomes in the elderly, more older adults with significant hearing loss may benefit from this intervention.

The findings add to a growing body of research indicating that cochlear implants can significantly improve quality of life in older adults, even those of advanced age with various health conditions. For elderly patients with severe hearing loss who receive limited benefit from hearing aids, cochlear implants represent a viable option that can substantially enhance communication abilities and potentially protect against cognitive decline associated with untreated hearing loss.