Post-lingual 65+
This section outlines the benefits after cochlear implantation, challenges of hearing loss above 65 and factors influencing post operative results.
Each publication listed below is rated by its importance for patients, using a Hearring key icon scale 🔑— e.g. one key for low importance, three keys for medium importance, and five keys for high importance.
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low importance for patients
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the highest importance for patients
Challenges
of hearing loss for adults
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1. “It is well known that hearing loss has a considerable impact on individuals’ daily life, untreated hearing loss can lead to communication problems, social isolation, loneliness, and higher anxiety and depression rates.” (Vandenbroeke et al. 2025)
2. “In hearing-impaired patients, the listening effort required to improve communication leads to mental fatigue with a negative effect on cognitive resources being available for other cognitive tasks, resulting in cognitive decline.” (Mosnier et al. 2015)
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1. Progressive age-related hearing loss not only affects speech understanding and daily communication, but also social functioning.” (Lammers et al. 2025)
2. “The impact that even mild to moderate hearing loss, when unaddressed, has on individual’s ability to enjoy life to the full should not be underestimated: As well as listening and communication, hearing loss can affect mental health, social integration and employment.” (Cuda et al. 2024)
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1. “The impact that even mild to moderate hearing loss, when unaddressed, has on individual’s ability to enjoy life to the full should not be underestimated: As well as listening and communication, hearing loss can affect mental health, social integration and employment.” (Cuda et al. 2024)
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1. “It is well known that hearing loss has a considerable impact on individuals’ daily life, untreated hearing loss can lead to communication problems, social isolation, loneliness, and higher anxiety and depression rates.” (Vandenbroeke et al. 2025)
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1. “In the past two decades there is accumulating evidence indicating that untreated hearing loss is associated with a higher risk of cognitive decline and dementia. In 2020, and again in their 2024 update, the Lancet Commission on Dementia concluded that hearing loss is the most important modifiable risk factor for dementia.” (Lammers et al. 2025)
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1. “Due to changes in communication patterns, quality of life is strongly reduced in hearing-impaired subjects. According to the National council on the Aging Report comprising 4394 participants only 39% of hearing-impaired elderly have an excellent health compared to 68% in the general population.” (Völter et al. 2020)
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1. “It is well known that hearing loss has a considerable impact on individuals’ daily life, untreated hearing loss can lead to communication problems, social isolation, loneliness, and higher anxiety and depression rates.” (Vandenbroeke et al. 2025)
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1.“This research study shows that spouses of older people with hearing impairment experience third-party disability as a result of their partners’ hearing impairment and that the SOS-HEAR could be used to identify the nature of the disability.” (Scarinci et al. 2012)
2.“Hearing loss poses a significant public health challenge among older adults, necessitating urgent interventions such as early screening, expanded access to hearing aids, and environmental noise control.” (Qingchun et al. 2025)
Benefits
after cochlear implantation
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1. “This prospective study demonstrates that cochlear implantation improves speech perception in an elderly population in quiet and in noise at 6 months after implantation, which is consistent with previously reported research. Speech perception continues to improve in quiet between 6 and 12 months, and was shown to remain stable for performance in noise after 6 months.”
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1. “Our results suggest that, by improving hearing for verbal communication, cochlear implantation decreases the cognitive load and, as a consequence, may have a positive effect on attention, concentration, and executive function.” (Mosnier et al. 2015)
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1. “In particular, “Social participation” as a treatment success directly experienced by the patient reaches the level of the general population within only 6 months postoperatively and even exceeds this level 6 years after CI treatment.” (Issing et al. 2024)
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1. “Our study data demonstrate a rapid and stable improvement in quality of life over the 6 years in elderly patients over the age of 65.” (Issing et al. 2024)
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1. “Better hearing not only improved individuals’ ability to communicate verbally, but also their ability to function independently on a daily basis.” (Cuda et al. 2024)
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1. “20% of the subjects aged 65–85 years had an abnormal score on at least three out of six subtests before CI provision; this decreased to only 5% after cochlear implantation. In general, cognitive functions significantly improved at six or at 12 months of CI use (22, 24).” (Völter et al. 2022)
More: Claes et al. 2018, Vasil et al. 2020, Zhan et al. 2020
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1. “They appeared to feel less lonely and felt less handicapped by their hearing loss. Clinically and statistically significant gains in health utility, independence, loneliness, hearing ability and hearing handicap were observed regardless of young, middle or old old age group.” (Cuda et al. 2024)
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1. “Partners described being less concerned about the safety of the CI recipient, a reduction in the need for them to act as an interpreter for their spouse, and a reduction in stress associated with caring for their partner following cochlear implantation. Cochlear implantation has been found to enhance autonomy, normalcy, and social life satisfaction for CI recipients and, importantly, their partners.”
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1. “After 1 year of CI use, the mean depression scores decreased significantly in both age groups: from 5.8±4.3 to 4.4±4.2 in the<60y group and from 7.3±5.3 to 6.3±4.4 in the≥60y group (Fig. 5C). A decrease in the depression scores was reported by 82% of participants in the<60 group and by 50% in the ≥60y group.”
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1. “Better hearing not only improved individuals’ ability to communicate verbally, but also their ability to function independently on a daily basis.” (Cuda et al. 2024)
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1. “Better hearing not only improved individuals’ ability to communicate verbally, but also their ability to function independently on a daily basis.” (Cuda et al. 2024)
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1. “Better hearing not only improved individuals’ ability to communicate verbally, but also their ability to function independently on a daily basis.” (Cuda et al. 2024)
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1. “Better hearing not only improved individuals’ ability to communicate verbally, but also their ability to function independently on a daily basis.” (Cuda et al. 2024)
Influencing Factors
Post-operative results
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1. “The candidate’s family and friends should be encouraged to become involved in all aspects of pre- and post-implant management. This should be done only with the permission of the candidate and at the discretion of the CI team.” (Távora-Vieira 2020)
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1. “Figure 2 shows postoperative CNC word score as a regression on duration of deafness. When we took both age groups together, there was a general decrease in word score with increasing duration of deafness.” (Leung et al 2005)
2. ”DoD [duration of deafness] is one of the most important factors to predict speech perception after cochlear implantation in postlingually deaf patients. The meta-analyses revealed a negative correlation between length of auditory deprivation and postoperative sentence and monosyllabic speech perception. Longer DoD seems to lead to worse CI performance, whereas more experience with CI mitigates the effect.“ (Bernhard et al. 2021)
3. “Based on the present findings, it can be concluded that the underlying etiology and the duration of deafness are important predictors for speech outcome in SSD patients.”
More: Sanchez-Cuadrado 2013
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1. “Several authors have posited that hours of auditory input or CI use per day have a significant effect on socialization and other psychosocial outcomes [26, 33].” (Marx et al. 2020)
More: Giroud et al 2017
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1. “Rehabilitation of hearing communication through cochlear implantation in elderly patients results in improvements in speech perception and cognitive abilities and positively influences their social activity and quality of life.” (Mosnier et al. 2015)
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1. “However, if the elderly suffer from comorbidities, an influence on postoperative speech comprehension can be suspected, especially if multimorbidities or neurological comorbidities are present.” (Illg et al. 2022)
2. “Der Erfolg einer Cochlea-Implantat (CI)-Versorgung kann durch veränderte kognitive Fähigkeiten beeinträchtigt sein.“ (Illg et al. 2018)
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1. “In our study, the improvement was slightly greater for patients who underwent CI before 70 years of age than in those implanted later in life, but the difference was not significant. Interestingly, a significant negative correlation existed between age and the speech perception of disyllables without lipreading and with masking. This finding indicates that the older the patient´s age at CI, the worse the speech perception in noise.” (Sanchez-Cuadrado et al. 2013)
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1. “Individuals may choose to ignore HL as it may represent a stigma associated with getting old. Additionally, HL is considered a normal part of aging and, therefore, not worth reporting. These reasons highlight the importance, and urgency, to uncover and confirm the most promising methods and techniques that support healthy aging, especially by addressing currently available treatments that may modify debilitating effects such as HL.” (Marx et al. 2020)
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1. “Seven studies found no significant correlation between insertion depth and speech perception outcomes (9,22,31,37,41,42,44).
Fifteen studies reported a positive effect or significant positive correlation between insertion depth and speech perception (11,13,29,30,32–36,38–40,43,45,46) (Table 2).” (Breitsprecher et al. 2023)
2. “Longer electrode insertions (and greater insertion angles) appear to offer better speech perception performance in the early postactivation period when using the same implant system.” (Buchman et al. 2014)
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1. “Comorbidities without cognitive or neurological involvement (e.g., heart insufficiency and limited motor skills) also lead to less speech comprehension postoperatively. The more comorbidities an elderly person has, the less the postoperative speech comprehension develops with CI.” (Illg et al. 2022)
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1. “The impact of etiology and duration of deafness on speech perception outcomes in SSD patients | European Archives of Oto-Rhino-Laryngology” (Kurz et al.)
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1. “In this paper, we describe very close matches to CI sound quality, i.e., similarity ratings of 9.5 to 10 on a 10-point scale, by ten patients fit with a 28 mm electrode array and MED EL signal processing.” (Dorman et al. 2024)