Abstract
Older adults with mild or no hearing loss make more errors and expend more effort listening to speech. Cochlear implants (CI) restore hearing to deaf patients but with limited fidelity. We hypothesized that patient-reported hearing and health-related quality of life in CI patients may similarly vary according to age. Speech Spatial Qualities (SSQ) of hearing scale and Health Utilities Index Mark III (HUI) questionnaires were administered to 543 unilaterally implanted adults across Europe, South Africa, and South America. Data were acquired before surgery and at 1, 2, and 3 years post-surgery. Data were analyzed using linear mixed models with visit, age group (18–34, 35–44, 45–54, 55–64, and 65+), and side of implant as main factors and adjusted for other covariates. Tinnitus and dizziness prevalence did not vary with age, but older groups had more preoperative hearing. Preoperatively and postoperatively, SSQ scores were significantly higher (Δ0.75–0.82) for those aged <45 compared with those 55+. However, gains in SSQ scores were equivalent across age groups, although postoperative SSQ scores were higher in right-ear implanted subjects. All age groups benefited equally in terms of HUI gain (0.18), with no decrease in scores with age. Overall, younger adults appeared to cope better with a degraded hearing before and after CI, leading to better subjective hearing performance.
Highlights
Cochlear implants (CI) are the treatment of choice to restore the reception of sound when hearing aids no longer provide an adequate level of speech understanding for the listener to function in everyday situations
Our study examined the relationship between the side of implantation and age and self-reported hearing performance and health status in 543 hearing-impaired adults receiving a cochlear implant in one ear
age-related hearing loss (ARHL) represents a complex, progressive change to the auditory system at the level of hair cell integrity and afferent synaptic interactions connecting them to the auditory nerve that may include synaptopathy (Sergeyenko et al, 2013; Tu and Friedman, 2018). It may not be surprising, that our findings showed a difference between the younger and older Implant Recipient Observational Study (IROS) participants starting in their mid-50 s when the symptoms of ARHL and synaptopathy begin to emerge
Summary
Cochlear implants (CI) are the treatment of choice to restore the reception of sound when hearing aids no longer provide an adequate level of speech understanding for the listener to function in everyday situations. A significant level of background noise requires listeners with intact hearing to exert more effort to receive and repair target speech, such as by utilizing strategies of auditory closure (Madix, 2006). Even in noise-free situations, CI users and other hearing-impaired individuals need to expend significant cognitive resources to hear and understand the message (Stahl, 2017). Hearing is receiving auditory signals, and listening is cognitively organizing what has been received. By contrast, listening is a top-down process (André et al, 2019) and may, be impacted by the capacity of listening processes further up the network that relies on cognitive function and may suffer age-related impairment (Rosemann and Thiel, 2019)
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