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Hearing Is Timeless How elderly people benefit from hearing implants when hearing aids are no longer enough

Read more Last updated: February 2020
In collection Age
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Hearing well in old age increases your chances of staying independent, physically active and mentally agile. If hearing aids are no longer enough, cochlear implants can help restore hearing - and enjoyment of life.

Hearing is essential for human interactions

People need each other. We need conversation both to develop our sense of individuality and to help us feel that we belong. One pre-condition for communication is a common language. But in many people, the ability to hear – and communicate with others – decreases with age. The World Health Organization estimates the number of people with age-related hearing loss at 300 million – equivalent to the population of the USA. In industrialised countries, between 50 and 60 per cent of over-70s are affected.

The medical term for age-related hearing loss is presbycusis. Typically, it’s a bilateral, symmetrical, advancing sensorineural hearing loss. In simple language, this means that it affects both ears and gradually progresses as more of the inner ear’s sensory hair cells become damaged or die. Initially, it starts with high-frequency sounds, making it difficult to understand conversations in noisy environments such as restaurants or bars. Over the years, people’s hearing deteriorates, and some of them communicate less and less because of it. As a result, many older people become isolated, which can in turn lead to depression.

Hearing loss and health

During the past few years, scientific research has confirmed a direct connection between hearing and thinking – if you put all your efforts into understanding speech, you have barely enough mental power left for other things. Researchers are now investigating whether there’s a connection between hearing loss and dementia.

One thing we do know for sure is that there’s a connection between restricted hearing and falls. Studies show that even a slight hardness of hearing can triple the risk of falling as walking and keeping your balance are cognitively demanding. When hearing loss takes up a significant amount of someone’s mental resources, it means there are fewer resources left for safety. Many hearing-impaired elderly people are afraid of falling so don’t move as much as they used to. As a result, the reduction in exercise raises their risk of falling even more.

How well older people hear has a wider social impact. Those who can hear well are more independent, agile and better anchored within society than those with hearing impairments. The more independent older people are, the less money is needed for social care services.

Hearing Loss

Hearing Loss and Our Health

More than 5% of the world's population have a hearing loss, and it often comes slowly and subtly. Thus affected persons delay seeking help for up to ten years. The longer they wait for treatment, the more a hearing loss might affect their overall health.

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Social benefits of a hearing solution

With profound hearing loss, a cochlear implant (CI) makes hearing possible again, thanks to technology. This can help the elderly to stay independent, physically and mentally active and integrated in society. Cochlear implants have been used successfully for more than 30 years and from a medical point of view there is no upper age limit for the operation, though different countries have different policies regarding implantation in the elderly.

In quiet surroundings, there is little difference between older and younger adults with CIs when it comes to understanding speech. However, there are slight differences in complex situations, such as noisy environments. In older people, the brain finds it more difficult to distinguish speech from background noise, with or without an implant.

How well you can hear with a CI depends on several factors. The people who get the best results tend to be those who haven’t experienced hearing loss for too long before the operation, are mentally active and agile and undergo regular training after implantation. As a general rule, the earlier the implantation is done, the better the result.

Many independent studies show that a CI followed by rehabilitation brings several benefits for elderly people: they understand speech better, they have more social contacts, a better quality of life and feel more confident. In short, they can communicate normally again.

Low-risk CI operation

A CI operation takes around one to two hours. In specialised CI clinics, the surgery is a routine procedure. However, it is important to manage existing conditions well before the operation – for instance, certain medication must be temporarily discontinued.

Dr Thomas Keintzel, Head of the ENT Department at the Wels-Grieskirchen Clinic, Austria, has been implanting for 10 years. He says: “Luckily, complications are very rare. Sometimes sense of taste can be temporarily affected and very rarely it can cause rotary vertigo – a feeling of dizziness – that usually disappears after three to four days.”

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