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Long-Term Use of Cochlear Implants in Older Adults: Results From a Large Consecutive Case Series

Choi, Janet S.*; Contrera, Kevin J.*; Betz, Joshua F.; Blake, Caitlin R.; Niparko, John K.§; Lin, Frank R.‡∥

doi: 10.1097/MAO.0000000000000327
Cochlear Implants

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.

*Johns Hopkins University School of Medicine; †Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health; ‡Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland; §Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of University of Southern California, Los Angeles, California; and Departments of Otolaryngology–Head & Neck Surgery, Geriatric Medicine, Mental Health and Epidemiology, Johns Hopkins University, Baltimore, Maryland, U.S.A.

Address correspondence and reprint requests to Frank R. Lin, M.D., Ph.D., Johns Hopkins Center on Aging & Health, 2024 Monument St, Suite 2-700, Baltimore, MD 21287; E-mail:

Funding: This manuscript was supported in part by NIH K23DC011279, the Eleanor Schwartz Charitable Foundation, a Triological Society/American College of Surgeons Clinician Scientist Award, and an Alpha Omega Alpha Carolyn L. Kuchein Student Research Fellowship.

Disclosures: Dr. Lin reports being a consultant to Cochlear, on the scientific advisory board for Autifony and Pfizer, and a speaker for Med El and Amplifon.

Copyright © 2014 by Otology & Neurotology, Inc. Image copyright © 2010 Wolters Kluwer Health/Anatomical Chart Company