Cochlear implants slightly less beneficial in older patients

Older adults appear to benefit significantly from cochlear implants, but not as much as younger patients who had similar levels of hearing impairment before surgery, according to a new study by researchers at The Medical College of Wisconsin in Milwaukee. The study was reported in the May issue of Archives of Otolaryngology - Head & Neck Surgery.

Cochlear implants have become an accepted treatment for adults with age-related hearing loss or the progression of early-onset hearing loss, according to background information in the article. Adults age 65 and older are becoming an increasing proportion of the current U.S. population. As such, the number of older cochlear implant candidates is expected to increase, as well as their mean [average] age at presentation.

David R. Friedland, M.D., Ph.D., associate professor of otolaryngology, and colleagues at the Medical College studied the medical records of patients at Froedtert Hospital who received cochlear implants at age 65 or older between 1999 and 2008. Each of 28 older patients was matched to a younger patient (receiving an implant at ages 18 to 64) with similar pre-implantation hearing test scores.

One year after implantation, 55 of the 56 total patients showed improvement on hearing testing. Regardless of their age at implantation, higher test scores before surgery predicted higher test scores afterward. However, the older patients performed more poorly than younger patients on some speech perception tests at the one-year follow-up.

"One explanation for these results is that elderly patients may simply take longer than one year to reach maximum levels of performance," says Dr. Friedland. "Alternatively, the performance of elderly patients may be affected by associated medical and cognitive conditions that are not as common in younger adults"

According to Dr. Friedland, the results may help clinicians set realistic expectations for post-implantation results in older patients. This study also found that the better a person's hearing before the implant, the better they do with the implant.

He adds, "These data suggest that consideration should be made to expand the implant criterion in the elderly. This would allow those with progressive age-related hearing loss to be implanted at a younger age and with better hearing so as to maximize post-implant performance."