The Role of Age on Cochlear Implant Performance, Use, and Health Utility

Abstract

OBJECTIVE: To use data obtained in a multicenter clinical trial to evaluate factors affecting performance with an implant, with special emphasis on the effect of age on performance. STUDY DESIGN AND SETTING: Post hoc analyses of data collected during a multicenter prospective study to evaluate performance with a recently introduced cochlear implant (CI) system conducted at 13 academic centers in the United States. Subjects participated in speech recognition testing in quiet and noise and completed questionnaires regarding health utility and processor use. PATIENTS: Thirty-eight adults with moderate to profound hearing loss who ranged in age from 18 to 89 years. Subjects were divided into younger (<65 yr, n = 20) and older (≥65 yr, n = 18) groups for the analyses. INTERVENTION: All subjects received a multichannel CI system. Preimplant to postimplant change in speech recognition was evaluated for each group, and the performance of the two groups was compared. Postimplant performance of older subjects who scored greater than 40% preimplant on HINT (Hearing in Noise Test) sentences was also evaluated. Linear regression was used to further evaluate the effects of variables on outcomes. RESULTS: Both younger and older subjects demonstrated significant improvement in speech recognition and hearing health utility after receiving a CI, and differences between groups were insignificant. Older subjects who scored greater than 40% preoperatively on HINT sentences demonstrated a significant improvement in speech recognition. CONCLUSION: Both older and younger patients can receive significant improvement in speech recognition and health utility after receiving a CI.