Advanced age is not a predictor for cochlear implantation outcomes in adults with moderate to profound sensorineural hearing loss

Objective: Hearing impairment is a common disability in elderly people. With an ageing population, it is expected that the number of people with age-related hearing loss will grow, and a proportion are likely to become Cochlear Implant (CI) candidates. The aim of this study is to investigate whether the age at which a person receives a CI has an impact on their objective speech understanding outcomes and subjective, self-reported outcomes within the first 12-months of CI use. Methods: 242 CI recipients participated in this study. Participants were divided into 3 groups according to age at implantation: 72 younger adults (18–60 years); 109 older adults (60–75 years); and 65 elderly adults (>75-years). Benefit of CI use was assessed via speech understanding and patient-reported measures. Speech understanding in quiet was assessed via the Consonant-Nucleus-Consonant words test. Speech understanding in noise was assessed via the Bamford-Kowal-Bench Adaptive speech-in-noise test. Self-perceived hearing ability was assessed via the short from of the Speech, Spatial and Qualities of Hearing scale. Tinnitus reduction, if applicable, was assessed via the Tinnitus Reaction Questionnaire. All 4 assessments were completed at 4 intervals: preoperatively, 3-, 6-, and 12-months of CI use. Results: For the entire cohort over time, significant improvements were found for speech understanding in quiet (p < 0.0001), and self-perceived hearing ability (p < 0.0001). Between the three groups, there were no significant differences in any postoperative (post-Op) assessment for all study outcomes. Conclusion: Each age group had improved speech understanding and self-perceived hearing abilities after 12-months of CI use. No significant differences were found between groups at all post-Op test intervals. We therefore conclude that elderly people (>75-years) who are acceptable CI candidates should be offered the same opportunity to benefit from CI use as younger adult candidates. Level of evidence: Level 3.