Cochlear implants: the effects of age on outcomes

ABSTRACT

Introduction

Cochlear implants (CIs) provide access to sound for children and adults who do not receive adequate benefit from hearing aids. Age at implantation is known to affect outcomes across the lifespan.

Areas covered

The effects of age on CI outcomes are examined for infants, children, adolescents, and older adults. A variety of outcome measures are considered, including speech perception, language, cognition, and quality of life measures.

Expert Opinion/Commentary

For those meeting candidacy criteria, CIs are beneficial at any age. In general, younger age is related to greater benefit when considering pre-lingual deafness. Other factors such as additional disabilities, may mitigate this effect. Post-lingually deafened adults demonstrate similar benefit regardless of age, though the oldest individuals (80+) may see smaller degrees of improvement from preoperative scores. Benefit can be measured in many ways, and the areas of greatest benefit may vary based on age: young children appear to see the greatest effects of age at implantation on language measures, whereas scores on cognitive measures appear to be most impacted for the oldest population. Future research should consider implantation at extreme ages (5–9 months or > 90 years), unconventional measures of CI benefit including qualitative assessments, and longitudinal designs.

KEYWORDS:

• Cochlear implant
• review
• age
• children
• adults
• outcomes

Article highlights

• For those that meet candidacy criteria, a CI is beneficial for anyone over 5 months of age.

• Earlier implantation almost always leads to better outcomes as the duration of auditory deprivation and neural degradation is shorter.

• Benefit from a CI can be measured in many ways, including speech perception, language, quality of life, social or employment measures, or cognition.

• The way benefit is measured will depend on the age of the person and their duration of deafness. The influence of age at implantation on outcomes for special populations, such those with additional disabilities, residual hearing, or unilateral deafness, may be different than more typical patterns of hearing loss.

• Future research will expand on additional ways of quantifying CI outcomes (including imaging and other objective measures), implantation for the youngest (under 9 months) and oldest (over 90 years) populations, and longitudinal studies.

Declaration of interest

E Spitzer receives unrelated grant funding from Cochlear Americas. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper utilized departmental funding.