Cochlear implant in elderly deaf patients with adverse predictors of audiological outcome

BACKGROUND: Auditory rehabilitation of elderly cochlear implant recipients represents a clinical challenge considering aging-associate mental decline in association with duration, onset and grade of hearing loss. The aim of the study was to determine whether elderly patients (>65 years) with severe post-lingual hearing loss and negative prognostic factors would benefit from cochlear implant. METHODS: Cognitive performance (via a battery of 12 neuropsychological tests), speech recognition scores, and hearing benefit were evaluated before cochlear implant and after 6 months in a group of 10 geriatric patients (>65 years) with at least one of the following adverse prognostic factors: age >80 years, auditory deprivation >10 years, postlingual hearing loss onset in childhood, with a duration of moderate-to-severe hearing loss >50 years. RESULTS: Mean speech recognition score was 55% after cochlear implant and the improvement was independent of age, sex, and cognitive performance. At the 6-month cognitive evaluation, the scores on 11 of the 12 neuropsychological tests showed improvements over baseline. The mean Mini Mental State Examination showed a statistically significant difference (P=0.02) and lower scores at baseline were predictive for higher scores at 6 months. CONCLUSIONS: A lower mean speech recognition score as compared with published data was observed. An improvement in hearing benefit and neuropsychological test scores is shared by previous reports. The new finding is that such improvement can be obtained even in a selected group of older patients with adverse prognostic factors of audiological outcome.