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Cochlear Implants Effective in Older Patients with Age-Related Hearing Loss

by Jennifer L.W. Fink •

For most post-lingually deafened adults, adjusting to life with a cochlear implant is “like riding a bike,” said Robert Labadie, MD, PhD, professor of otolaryngology and biomedical engineering at Vanderbilt University in Nashville, Tenn. But “some patients may not like it,” Dr. Gantz said. “They may be disappointed that it doesn’t generate the information they thought it would immediately; sometimes it takes time, and there’s variability of performance. Not everybody gets to 80 or 90 percent word understanding.”

Additionally, some studies have suggested that older adults, especially those older than age 75, are more likely to experience balance problems post-cochlear implantation than younger adults (Otol Neurotol. 2013;34:1272-1277). Preparing patients (and families) for the possibility of balance difficulties after surgery may increase patient safety and satisfaction. “We need to counsel patients and let them know that if they are having balance problems before surgery, they may have more after,” Dr. Labadie said. “We want them to be aware so they can take appropriate measures and not put themselves in unsafe settings.”

In the years to come, cochlear implantation of older adults is predicted to increase. “We are literally at the tip of the iceberg in terms of the crush of older adults who are aging but very healthy and want to live to their full potentials,” Dr. Lin says. “I think there’s going to be a huge increase in the number of patients who will qualify and who are likely to want a cochlear implant.”

Are We Ready?

While experts predict an increase in the number of adults seeking cochlear implants, serious questions remain about the ability of the otolaryngology and audiology communities’ ability to handle an influx of patients. “In many ways, the surgery is the easiest part of the process. The bigger issue in terms of workforce is the availability of well-qualified audiologists who have the time and infrastructure to do cochlear implantation programming, counseling and rehabilitation,” Dr. Lin said.

Accessibility is another key concern. At present, many patients travel hours to reach a medical center with expertise in cochlear implantation. To accommodate larger numbers of patients, alternative models of care such as satellite clinics or remote programming may be needed.

Limited hearing may also directly affect an individual’s ability to care for his or her health. “When someone has a chronic illness and age-related hearing loss, they may have difficulty communicating with their physicians and caregivers,” Dr. Friedland said. “There are significant considerations about cochlear implantation as an option to help improve communication to coordinate the administration of medical care for chronically ill older adults.”