Age-Dependent Psychological Factors Influencing the Outcome of Cochlear Implantation in Elderly Patients

Introduction: Increasing number of older adults undergo cochlear implantation (CI). Accumulating evidence implicates that the outcome of implantation may not only depend on physical and psychological health status of patients but also on their age. In the present work, we analyzed the elderly (70-80) and very old (80+) patients who underwent CI regarding their hearing abilities, health-related quality of life (HRQoL), and psychological comorbidities. Patients and Methods: Eighty-six patients were included in this prospective study. The patients were split into two groups: 70-80 years-old (n = 62) and >= 80 years-old (n = 24). Hearing performance was assessed with Freiburg monosyllabic test and Oldenburg inventory (OI); the health-related quality of life was measured with Nijmegen Cochlear Implantation Questionnaire (NCIQ); depressive symptoms with General Depression Scale (ADS-L); stress with Perceived Stress Questionnaire (PSQ) and anxiety with General Anxiety Disorder-7 (GAD-7). Results: Prior to CI, the hearing performance (O1) impacted positively the HRQoL of both groups whereas the perceived stress (PSQ) had a negative impact. Six months after implantation, the HRQoL of 70-80 group was still positively influenced by the hearing performance (O1) whereas HRQoL of 80+ group was influenced by stress perception (negative impact) and anxiety (positive impact). Twelve months later, anxiety and depressive symptoms correlated negatively with HRQoL of both age groups. Hearing performance had the positive and anxiety the negative impact on HRQoL in both groups but in addition, the 80+ group seemed to benefit from an increased level of anxious symptoms. Conclusion: In elderly patients, the outcome of CI depends on their psychological status. Differences found between the age groups imply a need for an age-group targeted psychological counselling, which might further improve outcome of CI.