Cochlear Implants Help Senior Citizens Hear But Help
Younger Patients Slightly More
Seniors performed more poorly than younger patients
on some speech perception tests at the one-year follow-up
May
17, 2010 – A study of senior citizens concludes that older adults appear
to benefit significantly from cochlear implants, but not as much as
younger patients who had similar levels of hearing impairment before
surgery, according to a report in the May issue of Archives of
Otolaryngology-Head & Neck Surgery, one of the JAMA/Archives
journals.
Cochlear implants have become an accepted treatment
for adults with age-related hearing loss or the progression of
early-onset hearing loss.
Adults age 65 and older are becoming an increasing
proportion of the current U.S. population. "As such, the number of older
cochlear implant candidates is expected to increase, as well as their
mean [average] age at presentation," the authors write.
David R. Friedland, M.D., Ph.D., and colleagues at
the Medical College of Wisconsin, Milwaukee, studied the medical records
of 28 patients who received cochlear implants at age 65 or older between
1999 and 2008. Each one was matched to a younger patient (receiving an
implant at ages 18 to 64) with similar pre-implantation hearing test
scores.
One year after implantation, 55 of the 56 total
patients showed improvement on hearing testing. Regardless of their age
at implantation, higher test scores before surgery predicted higher test
scores afterward. However, the older patients performed more poorly than
younger patients on some speech perception tests at the one-year
follow-up.
"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."
The results may help clinicians set realistic
expectations for post-implantation results in older patients, the
authors note.
"This study also found that better pre-implantation
performance predicts better post-implantation scores in the elderly and
younger patient," they continue. "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."
This work was supported by the Toohill Research
Fund within the Department of Otolaryngology and Communication Sciences,
Medical College of Wisconsin.
What is a cochlear implant?
A cochlear implant is a small, complex
electronic device that can help to provide a sense of sound
to a person who is profoundly deaf or severely
hard-of-hearing. The implant consists of an external portion
that sits behind the ear and a second portion that is
surgically placed under the skin (see figure). An implant
has the following parts:
● A microphone, which picks up sound
from the environment.
● A speech processor, which selects
and arranges sounds picked up by the microphone.
● A transmitter and
receiver/stimulator, which receive signals from the speech
processor and convert them into electric impulses.
● An electrode array, which is a
group of electrodes that collects the impulses from the
stimulator and sends them to different regions of the
auditory nerve.
An implant does not restore normal
hearing. Instead, it can give a deaf person a useful
representation of sounds in the environment and help him or
her to understand speech.
May
17, 2010 – A study of senior citizens concludes that older adults appear
to benefit significantly from cochlear implants, but not as much as
younger patients who had similar levels of hearing impairment before
surgery, according to a report in the May issue of Archives of
Otolaryngology-Head & Neck Surgery, one of the JAMA/Archives
journals. 