Cochlear Implantation and the Elderly

Cochlear implantation is generally considered a safe and effective recommendation for healthy adults who have bilateral, moderate-to-severe or moderate-to-profound sensorineural hearing loss and do not benefit from acoustic amplification (i.e., poor speech recognition).

However, given the large elderly population and the importance of timely hearing intervention, there is a need to more closely examine the hearing health-care needs of this population. Hammond-Kenny (2021) at Cambridge University Hospitals conducted a retrospective study to examine the complication rates, survival duration, audiological outcomes, and cost utility of cochlear implants for 126 recipients, ages 80 years and older.

Findings suggest acceptable complication rates and survival durations as well as impressive improvements in thresholds and speech recognition scores that are similar to improvements achieved by younger populations. Their findings suggest that adults of any age should be given equal access to cochlear implantation. Unfortunately, however, equal access is not always guaranteed in the United States.

Miller and colleagues (2020) report that adults with public health insurance (e.g., Medicare) often have to wait longer to receive cochlear implants and may experience poorer postoperative speech-perception outcomes than those with private insurance. Given the significant speech recognition and other benefits achieved by many adults who obtain cochlear implants, a continued focus on equal access, regardless of age and insurance status, is warranted.

References

Hammond-Kenny A, Borsetto D, Manjaly JG, et al. (2021) Cochlear implantation in elderly patients: survival duration, hearing outcomes, complication rates, and cost utility. Audiol Neurootol In press.

Miller SE, Anderson A, Manning, J Schafer EC. (2020) Insurance payer status predicts postoperative speech outcomes in adult cochlear implant recipients. J Am Acad Audiol 31(9):666–673.