Cochlear implant performance in geriatric patients

Objectives/Hypothesis: To evaluate the hearing performance with cochlear implants (CIs) in patients who were 70 years or older at the time of implantation (geriatric patients) and compare it with the performance in younger adults. Study Design: Individual, retrospective, cohort study. Methods: A cohort of 1,005 postlingually deafened adults was selected for this study. According to their age at the time of cochlear implantation, patients were divided into four age groups: group 1, 18 to 39 years; group 2, 40 to 59 years; group 3, 60 to 69 years; and group 4, 70 years and older). The test battery was composed of four standard German speech tests: Freiburger Monosyllabic Test, Speech Tracking Test, and Hochmair-Schulz-Moser (HSM) Sentence Test in quiet and in 10 dB noise. Results: Geriatric patients showed a similar learning curve as the younger adults in the first 2 years after implantation. The direct comparison of speech perception in the Freiburger Monosyllabic Test, Speech Tracking Test, and HSM Test in quiet revealed no differences between the average performance of the geriatric patients and younger adults. However, in the HSM Test in noise, the performance of the geriatric group was significantly lower than the younger adults. Conclusions: Geriatric CI patients have a similar learning curve to younger adults, and in speech tests in quiet they show a comparable performance. However, their performance is significantly lower in noisy surroundings. This may be due to the central presbycusis in patients older than 70 years and should be taken into account in postoperative fitting of these patients. Further prospective studies are required to evaluate the role of special rehabilitation methods and cognitive training to improve the speech perception in noise in geriatric CI patients.