More older adults have turned to cochlear implants after Medicare expanded eligibility for the devices.
Kitty Grutzmacher had contended with poor hearing for a decade, but the problem had worsened over the past year. Even with her hearing aids, “there was little or no sound,” she said.
“I was avoiding going out in groups. I stopped playing cards, stopped going to Bible study, even going to church.”
Her audiologist was unable to offer Ms. Grutzmacher, a retired nurse in Elgin, Ill., a solution. But she found her way to the cochlear implant program at Northwestern Medicine.
There, Krystine Mullins, an audiologist who assesses patients’ hearing and counsels them about their options, explained that surgically implanting this electronic device usually substantially improved a patient’s ability to understand speech.
Kitty Grutzmacher had contended with poor hearing for a decade, but the problem had worsened over the past year. Even with her hearing aids, “there was little or no sound,” she said.
“I was avoiding going out in groups. I stopped playing cards, stopped going to Bible study, even going to church.”
Her audiologist was unable to offer Ms. Grutzmacher, a retired nurse in Elgin, Ill., a solution. But she found her way to the cochlear implant program at Northwestern Medicine.
There, Krystine Mullins, an audiologist who assesses patients’ hearing and counsels them about their options, explained that surgically implanting this electronic device usually substantially improved a patient’s ability to understand speech.
At Northwestern, Dr. Mullins tells older prospective patients that one year after activation, a 60 to 70 percent AzBio score — correctly repeating 60 to 70 words out of 100 — is typical.
A recent Johns Hopkins study of about 1,100 adults found that after implantation, patients 65 and older could correctly identify about 50 additional words (out of 100) on the AzBio test, an increase comparable to younger cohorts’ results.
Participants over 80 showed roughly as much improvement as those in their late 60s and 70s.
“They transition from having a hard time following a conversation to being able to participate,” said Dr. Della Santina, an author of the study. “Decade by decade, cochlear implant results have gotten better and better.”
Moreover, an analysis of 70 older patients’ experiences at 13 implantation centers, for which Dr. Wick was the lead author, found not only “clinically important” hearing improvements but also higher quality-of-life ratings.
Scores on a standard cognitive test climbed, too: After six months of using a cochlear implant, 54 percent of participants had a passing score, compared with 36 percent presurgery. Studies that focus on 80 and 90-year-olds have shown that those with mild cognitive impairment also benefit from implants.
Nevertheless, “we’re cautious not to overpromise,” Dr. Wick said. Usually, the longer that older patients have had significant hearing loss, the harder they must work to regain their hearing and the less improvement they may see.
A minority of patients feel dizzy or nauseated after surgery, though most recover quickly. Some struggle with the technology, including phone apps that adjust the sound. Implants are less effective in noisy settings like crowded restaurants, and since they are designed to clarify speech, music may not sound great.
For those at the upper end of Medicare eligibility who already understand roughly half of the speech they hear, implantation may not seem worth the effort. “Just because someone is eligible doesn’t mean it’s in their best interests,” Dr. Wick said.
For Ms. Grutzmacher, though, the choice seemed clear. Her initial testing found that even with hearing aids, she understood only 4 percent of words on the AzBio. Two weeks after Dr. Mullins turned on the cochlear implant, Ms. Grutzmacher could understand 46 percent using a hearing aid in her other ear.
She reported that after a few rough days, her ability to talk by phone had improved, and instead of turning the television volume up to 80, “I can hear it at 20,” she said.
So she was making plans. “This week, I’m going out to lunch with a friend,” she said. “I’m going to play cards with a small group of women. I have a luncheon at church on Saturday.”
The New Old Age is produced through a partnership with KFF Health News.
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