Cochlear Implantation Outcomes in Older Adults, Ages 80–90+

Objective: To assess whether postoperative speech recognition after cochlear implantation (CI) differ between age groups of 80 to 89 and 90+. Study Design: Retrospective cohort study. Setting: Tertiary academic referral center. Patients: Older adult (80+ years old) bilateral sensorineural hearing loss patients undergoing CI. Intervention(s): Therapeutic, CI. Main Outcome Measure(s): Speech testing battery at 3, 6, and 12 months postoperatively. Self-reported balance and vertigo symptoms were also assessed. Results: A total of 221 patients were included in this study, with 171 cases ages 80 to 89 and 50 cases ≥90 years old. A total of 60.3% had an abnormal preoperative cognitive screen based on either Montreal Cognitive Assessment or Mini Mental State Examination. No major demographic or clinical variables were noted across age groups. Mean 1 year postoperative speech scores were as follows for ages 80 to 89 versus 90+, respectively: CNC 50% (±21%) versus 47% (±18%), AzBio Quiet 54% (±26%) versus 50% (±25%), and AzBio +10SNR 28% (±21%) versus 21% (±17%). Age, abnormal cognitive screen, duration of hearing loss, and comorbidity measures such as BMI, Adult Comorbidity Evaluation-27, and American Society of Anesthesiology physical status class were not correlated with any speech measure. Overall rates of persistent self-reported balance symptoms at activation were 22.7%, decreasing to 7.5% at 1 year. Datalogging was >11 hours use on average for both age groups. Conclusions: CI speech recognition in the 80 to 89 and 90+ age range significantly improved from preoperative scores. No major speech recognition differences were identified between age groups. Age at implantation, abnormal cognitive screening, and comorbidity status did not influence speech perception, which suggests that candidacy in older adult CI patients should not be withheld strictly due to these parameters.