title: Impact of cochlear implants on the functional health status of older adults.
abstract: OBJECTIVE
  To assess the impact of cochlear implantation on quality of life changes in older adults aged 50 years and above.
  
  
  METHODS
  Retrospective study by questionnaire and chart review.
  
  
  METHODS
  Forty-seven patients aged 50 to 80 years (mean age, 63.4 y [SD = 8.6 y]), who have multiple-channel cochlear implants received at The Listening Center at Johns Hopkins Hospital, completed the Ontario Health Utilities Index Mark 3 survey and a questionnaire on quality of life changes. Health utility scores before and after cochlear implantation were measured, and audiologic data before implantation and at 6 months and 1 year after implantation were analyzed.
  
  
  RESULTS
  Cochlear implantation in older adults is associated with a mean gain in health utility(P <.0001) of 0.24 (SD = 0.33), which corresponds to a favorable cost-utility of $9530 per quality-adjusted life-year. Improvements in hearing and emotional health attributes were primarily responsible for this increase in health-related quality of life measure. There was a significant increase in speech perception scores at 6 months after surgery (P <.0001 for both CID sentence and monosyllabic word tests) and a strong correlation between the magnitude of health utility gains and the postoperative increase in speech perception scores (r = 0.45, P <.05).
  
  
  CONCLUSIONS
  Cochlear implants have a significant impact on the quality of life of older deaf patients, and are a cost-effective intervention in this population. Improvements in speech perception are predictive of gains in health-related quality of life and associated emotional benefits after cochlear implantation.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA. hfrancis@jhmi.edu
authors.forename: Howard W
authors.initials: HW
authors.lastname: Francis
authors.forename: Nelson
authors.initials: N
authors.lastname: Chee
authors.forename: Jennifer
authors.initials: J
authors.lastname: Yeagle
authors.forename: Andre
authors.initials: A
authors.lastname: Cheng
authors.forename: John K
authors.initials: JK
authors.lastname: Niparko
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003054:Cochlear Implants / Q000191:economics; D003362:Cost-Benefit Analysis; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D013067:Speech Perception; D011795:Surveys and Questionnaires