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

Objectives: Investigate rates of long-term use of cochlear implants (CI) in a large, consecutive case series of older adults (≥ 60 years) and characteristics associated with continuing CI use. Methods: From 1999-2011, 447 individuals ≥60 years received their first CI at Johns Hopkins, and we successfully contacted 397 individuals (89%) to ascertain data on the individual’s daily CI use averaged over the past 4 weeks. Regular CI use was defined as ≥8 hours/d. We investigated the time from implantation to the date when an individual reported discontinuing regular CI use with Kaplan-Meier and Cox proportional hazard analyses. Results: The overall rate of regular CI use at 13.5 years of follow-up was 82.6% (95% confidence interval: 72.5-89.3%). Individuals who received a CI at 60-74 years had significantly higher rates of regular CI use at 13.5 years of follow-up (91.1%, [95% confidence interval: 83.2-95.4%], n = 251) than individuals who received a CI at ≥75 years (55.7%, [95% confidence interval: 24.9-78.1%], n = 146). The rate of discontinuing regular CI use (<8 hours per day) increased on average by 7.8% (95% confidence interval: 3.0-12.8%) per year of age at implantation. Conclusions: Rates of long-term CI use in older adults at >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 the earlier implantation of older adults, once critically low levels of speech recognition are present, is associated with greater usage of the device.