title: Case-control analysis of cochlear implant performance in elderly patients.
abstract: OBJECTIVE
  To characterize speech perception performance in elderly cochlear implant users compared with younger adult users.
  
  
  METHODS
  Case-control retrospective analysis from January 1, 1999, to January 28, 2008.
  
  
  METHODS
  Tertiary care, academic practice cochlear implant program.
  
  
  METHODS
  Medical records for 78 patients with age at implantation of 65 years or older were analyzed for ear-specific preimplantation speech perception performance, length of deafness, age at implantation, and 1-year postimplantation speech perception performance. A subset of 28 elderly patients with complete data was matched to 28 younger adult patients (age at implantation, 18-64 years) for preimplantation performance using the Hearing in Noise Test-Quiet scores (mean, 22% and 23%, respectively).
  
  
  METHODS
  One-year postimplantation performance on word and sentence testing.
  
  
  RESULTS
  Within the elderly cohort, the Consonant-Nucleus-Consonant and Hearing in Noise Test-Quiet scores were not affected by age. The Hearing in Noise Test-Noise scores trended downward with increasing age but did not reach statistical significance (P = .052). Of the matched older and younger patients, 55 of 56 showed improvement in their 1-year postimplantation compared with preimplantation Hearing in Noise Test-Quiet scores, with better preimplantation performance predictive of better postimplantation performance, independent of age at implantation (P = .02). Group comparisons, however, revealed poorer postimplantation scores overall for the elderly patients compared with the younger ones for the Hearing in Noise Test-Quiet (70% vs 83%; P = .02) and the Consonant-Nucleus-Consonant test (38% vs 53%; P = .02).
  
  
  CONCLUSIONS
  Elderly patients benefit significantly from cochlear implantation. Compared with a younger cohort matched for preimplantation performance, however, their postimplantation scores are significantly lower on some measures. These results may provide guidelines for candidacy and counseling regarding elderly patients with cochlear implants.
authors.affiliation: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI 53226, USA. dfriedla@mcw.edu
authors.forename: David R
authors.initials: DR
authors.lastname: Friedland
authors.forename: Christina
authors.initials: C
authors.lastname: Runge-Samuelson
authors.forename: Humera
authors.initials: H
authors.lastname: Baig
authors.forename: Jamie
authors.initials: J
authors.lastname: Jensen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003054:Cochlear Implants; D005260:Female; D006320:Hearing Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013067:Speech Perception; D018709:Statistics, Nonparametric; D016896:Treatment Outcome