JAMA logo An accepted treatment for adults that could be suffering from age-related hearing loss is known to be cochlear implants. It may also help those on the progression of early-onset hearing loss. Nevertheless, a latest finding shares that though older adults may gain significantly from cochlear implants, the benefits acquired by younger patients who had similar levels of hearing impairment before surgery was higher.

“As such, the number of older cochlear implant candidates is expected to increase, as well as their mean [average] age at presentation,” the authors reveal.

For this analysis, the medical records of 28 patients who received cochlear implants at age 65 or older between 1999 and 2008 was examined by David R. Friedland, M.D., Ph.D., and colleagues at the Medical College of Wisconsin, Milwaukee. Each of these patients was matched to a younger patient who may have received an implant at ages 18 to 64. These patients shared similar pre-implantation hearing test scores.

About a year after implantation, it was observed that 55 of the 56 total patients had an improvement on hearing testing. Irrespective of their age at implantation, the higher test scores before surgery predicted higher test scores later. But at the one-year follow-up, older patients seemed to display poor performance than younger patients on certain speech perception tests.

“One explanation for these results is that the elderly patient may have a prolonged adaptation phase and reach levels attained by younger users at one-year postimplantation at a later point,” the authors write. “Alternatively, elderly patients may have inherent limitations in processing the high-rate stimulation paradigms used in current cochlear implants. Central cognitive or associative processes may also influence the performance in the population of elderly patients.”

“This study also found that better pre-implantation performance predicts better post-implantation scores in the elderly and younger patient,” continue the authors. “These data question whether implant criteria in elderly patients should be expanded. This would allow those with significant progressive presbycusis [age-related hearing loss] (i.e., destined to meet implant criteria) to undergo implantation earlier, thus maximizing their postimplantation performance.”

The outcome of this finding according to the authors could aid clinicians in setting expectations that are more realistic for post-implantation results in older patients.

The May issue of Archives of Otolaryngology—Head & Neck Surgery, one of the JAMA/Archives journals features this article.