Restoring Hearing, Enhancing Life: Cochlear Implantation Outcomes in the Elderly

Abstract

Moamen Abdelfadil Ismail*, Abdalrahman T. Albader, Ali Hassan Sadar Din, Abdulrahman Abdullah S Alelyani, Shahad Mohammed Albariqi, Reema Nasser Alshaya, Abdulrahman Saeed Hussain Almuaddi, Lena A. Almathami, Yara Saad Awad Alanzi, Mohammed Atiah Alzahrani, Joud Hatam Damanhuri, Hussein Jaddoa Shukur Al Bawi, Nawaf A. Almutairi and Hassan Mansour ALBarakati

Background: Hearing loss is highly prevalent among older adults and is associated with cognitive decline, social isolation, and reduced quality of life. Cochlear implantation (CI) is increasingly utilized as an intervention for severe-to-profound hearing loss in this population. This review systematically examines outcomes related to auditory function, cognitive performance, and quality of life after CI in older adults.

Objectives: To synthesize and critically evaluate empirical evidence regarding the efficacy, cognitive benefits, safety, and psychosocial outcomes of cochlear implantation in individuals aged 60 years and older.

Methods: A systematic review methodology was employed, following PRISMA 2020 guidelines. Searches were conducted across PubMed, Scopus, Web of Science, and Embase for peer-reviewed studies published between 2010 and 2024. Inclusion criteria encompassed studies with older adult populations undergoing CI, reporting on at least one of the following: cognitive outcomes, speech perception, QoL metrics, or safety. Both qualitative and quantitative studies were included.

Results: Twenty-two studies met inclusion criteria. CI in older adults resulted in consistent improvements in speech recognition, verbal communication, emotional well-being, and cognitive function. These benefits were observed across varied age ranges, including the very elderly. Comorbidity presence did not substantially increase surgical risk. Several studies reported enhanced executive function, memory, and decreased depressive symptoms following implantation.

Conclusions: Cochlear implantation offers substantial benefits for elderly patients, both in auditory and non-auditory domains. Age alone should not preclude candidacy. Comprehensive geriatric assessments and standardized referral pathways may enhance access and outcomes. Future research should emphasize long term follow-up, cognitive subdomains, and equity in care delivery.