In an American ageing society with more prevalent hearing loss, fewer geriatric patients are opting for cochlear implants (CI). This is mainly due to comorbidities and potential complications. Authors conducted a retrospective review of CI patients from 2015 till 2021. They planned a sub-cohort of over 90 years of age and did not exclude patients with lower scores on cognition tests Mini Mental State and Montreal cognitive assessment. Comorbidities were assessed using ACE-27 and ASA. Balance was assessed before and after implantation. The study included 175 patients aged between 80 and 89 and 51 patients who were ≥90 years old. The majority of patients were white (95.9%) males (66.1%), and the most common aetiologies of hearing loss included presbycusis (33.6%) with another third of unknown pathology. Sixty percent of patients had abnormal cognitive screening. Ninety percent had one or more comorbidities (92.6%) on ACE-27, with the most common comorbidity being cardiovascular in nature. Overall rates of persistent self-reported balance symptoms at activation were 22.7%, decreasing to 7.5% at one year. Age at implantation, duration of hearing loss and duration of profound hearing loss were not correlated with any postoperative speech recognition. Additionally, abnormal screening result on MMSE or MOCA was not correlated with any postoperative speech recognition when stratified by age. Authors were clear about the limitations of this study including lack of formal preoperative balance assessment and the potential effect of fatigue in filling the cognitive questionnaires on lowering the scores. This is in addition to a possible selection bias and issues with speech tests. Despite the limitations, this study shows that neither age nor cognitive scores should be considered as contra-indication to cochlear implantation.
Cochlear implant and age
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