Long-term use of cochlear implants in older adults: Results from a large consecutive case series

OBJECTIVE: To investigate rates of long-term use of cochlear implants in a large, consecutive case series of older adults (?60 yr). STUDY DESIGN: Consecutive case series. SETTING: Tertiary referral center. PATIENTS: Approximately 447 individuals 60 years or older who received their first CI from 1999 to 2011. We successfully contacted 397 individuals (89%) to ascertain data on the individual's daily CI use averaged over the past 4 weeks. INTERVENTION: Cochlear implantation. MAIN OUTCOME MEASURE: Regular CI use was defined as 8 hours or greater of use per day. We investigated the time from implantation to the date when an individual reported discontinuing regular CI use. RESULTS: The overall rate of regular CI use at 13.5 years of follow-up was 82.6% (95% CI, 72.5%-89.3%). Individuals who received a CI at 60 to 74 years had significantly higher rates of regular CI use at 13.5 years of follow-up (91.1% [95% CI, 83.2%-95.4%], n = 251) than individuals who received a CI at 75 years or older (55.7% [95% CI, 24.9%-78.1%], n = 146). The rate of discontinuing regular CI use (<8 hr/d) increased on average by 7.8% (95% CI, 3.0%-12.8%) per year of age at implantation. CONCLUSION: Rates of long-term CI use in older adults at more than 10 years of follow-up exceed 80%. The rate of discontinuing regular CI use was strongly associated with older age at implantation. These results suggest that early implantation of older adults, once critically low levels of speech recognition are present, is associated with greater usage of the device.