Cochlear Implantation in Elderly Patients: Survival Duration, Hearing Outcomes, Complication Rates, and Cost Utility

Abstract

<b><i>Introduction:</i></b> The prevalence of hearing loss and its consequences is increasing as the elderly population grows. As the guidelines for cochlear implantation (CI) expand, the number of elderly CI recipients is also increasing. We report complication rates, survival duration, and audiological outcomes for CI recipients aged 80 years and over and discuss the cost utility of CI in this age group. <b><i>Methods:</i></b> A retrospective cohort study was undertaken of all CI recipients (126 cases), aged 80 years and over at the time of their surgery, implanted at our institution (Cambridge University Hospitals) during a period from January 1, 2001, to March 31, 2019. Data on survival at 1, 3, and 5 years post-implantation, post-operative complications and functional hearing outcomes including audiometric and speech discrimination outcomes (Bamford-Kowal-Bench sentence test) have been reported. <b><i>Results:</i></b> The mean age at implantation was 84 years. The mean audiometric score improved from 108 dB HL to 28 dB HL post-implantation. The mean Bamford-Kowal-Bench score improved from 14% to 66% and 73% at 2 and 12 months post-implantation, respectively. The complication rate was 15.3%. The survival probability at 1 year post-implantation was 0.95 for females and 0.93 for males, at 3 years was 0.89 for females and 0.81 for males, and at 5 years was 0.74 for females and 0.54 for males. <b><i>Conclusion:</i></b> CI is safe and well-tolerated in this age group and elderly patients gain similar audiometric and functional benefit as found for younger age groups.

Application of Patient Reported Outcome Measures in Cochlear Implant Patients: Implications for the Design of Specific Rehabilitation Programs

“…In recent years, after achieving strong, stable, and amazing results with verbal communication [33,34], CI research has focused much more on how to improve music listening and the participation of implanted patients [35].…”

Cochlear implantation performance outcomes in patients over 80 years old

“…Since there is a known association between cognitive abilities, brain plasticity, and postoperative CI speech perception some are skeptical of implantation in the very elderly or in elderly with multiple comorbidities including dementia 7,8 . The statistics are varied but some reports suggest that the elderly do not perform as well as younger counterparts, and overall health concerns often discourage the 80 plus year‐olds from pursuing a CI 6,7,9,10 …”

“… 7 , 8 The statistics are varied but some reports suggest that the elderly do not perform as well as younger counterparts, and overall health concerns often discourage the 80 plus year‐olds from pursuing a CI. 6 , 7 , 9 , 10 …”

“…7,8 The statistics are varied but some reports suggest that the elderly do not perform as well as younger counterparts, and overall health concerns often discourage the 80 plus year-olds from pursuing a CI. 6,7,9,10 Despite expanding literature on cochlear implantation in the elderly, additional data that would help audiologists and physicians counsel the elderly on the benefits of hearing restoration by a CI are needed. A better understanding of CI use via modern recipient's sound process interrogations using processes such as "datalogging" help us better understand daily use patterns and environmental surroundings.…”

Do Not Go Gentle into That Deaf Night: A Holistic Perspective on Cochlear Implant Use as Part of Healthy Aging

“…People aged 65 years are more likely than other age groups to have comorbidities, often have multimorbidities, and may have additional handicaps [ 40 ]. Published data suggest that CI treatment in the elderly is safe and does not lead to an increase in complications [ 5 , 41 , 42 ]. Still, when considering the elderly and people with more and more complex comorbidities for CI treatment, it is also important to consider the risks associated with general anesthesia, which increase with age and comorbidities.…”