Younger age and greater hearing loss are independently associated with higher levels of loneliness in older adults presenting to clinic for hearing loss treatment. Further studies needed to determine whether hearing treatment can reduce loneliness in older adults.

There was a significant improvement in depressive symptoms at 6 months after treatment for patients receiving cochlear implants and hearing aids; this improvement persisted to 12 months for those who received cochlear implants. Further research is warranted to assess the long-term effect of hearing rehabilitation on mental health in older adults.

Objective To investigate the impact of hearing aid and cochlear implant use on quality of life in adults. Study Design Prospective observational cohort study. Methods 113 adults aged ≥50 years with post-lingual hearing loss receiving routine clinical care at a tertiary academic medical center were evaluated with the Medical Outcome Study Short Form-36 before and 6 and 12 months after intervention with hearing aids or cochlear implants. Change in score was assessed using linear mixed effect models adjusted for age, gender, education, and history of hypertension, diabetes, and smoking. Results A significant increase in mental component summary score was observed in both hearing aid and cochlear implant users from baseline to 12 months, with cochlear implant users increasing nearly twice that of hearing aid users (hearing aid: 2.49 [95% confidence interval 0.11, 4.88], P =.041; cochlear implant: 4.20 [95% confidence interval 1.85, 6.55], P <.001). The most substantial increases were observed in individuals with the lowest baseline scores. There was no significant difference in physical component summary score from baseline to 12 months. Conclusions Treatment of hearing loss with hearing aids and cochlear implants results in significant increases in mental health quality of life. The majority of the increase is observed by 6 months post-treatment and we observed differential effects of treatment depending on the level of baseline quality of life score with the greatest gains observed in those with the lowest scores.

Objective: To determine the rate of long-term cochlear implant (CI) use in children Study Design: Consecutive case series Setting: Tertiary referral center Patients: 474 patients <18 years who received a first CI from 1999-2011 Interventions: Cochlear implantation Main Outcome Measure(s): Regular CI use, defined as using the CI for ≥ 8 hours per day Results: We successfully contacted and obtained follow-up data on 402 patients (85%) via email, telephone, and postal survey. The rate of regular CI use was 93.2% (95% CI, 90.0-95.4) at 5 years post-implantation and 87.7% (95% CI, 82.9-91.3) at 10 years post-implantation. The mean number of hours of use per day was 12.0 hours (SD, 4.1 hrs). Cox proportional hazard regression analysis demonstrated a linear association between the age at implantation and the risk of discontinuing regular CI use. Rates of CI discontinuation increased by 18.2% per year of age at implantation (95% CI, 7.2-30.4%). Reported reasons for CI use < 8 hours of per day include poor hearing benefit (53.2%), social pressure (21.3%), and recurrent displacement of the transmitter coil (17.0%). Conclusions: High rates of regular CI use are sustained after childhood implantation, and younger age at implantation is associated with a higher rate of continued device usage.

INTRODUCTIONHearing loss is prevalent in one in three people over the age of 50, and two-thirds of those older than 70 years. 1 Hearing loss in older adults impairs verbal communication, contributes to social isolation, 2 and has been independently associated with poorer cognitive functioning [3][4][5] and incident dementia. [6][7] While hearing aids improve audibility for most individuals with mild to moderate hearing loss, those who suffer from severe to profound hearing loss generally may acquire greater benefit from electrical hearing provided by a cochlear implant (CI). 8 Currently, the number of older adults in the United States who would potentially meet audiologic criteria for a CI is approximately 150,000, 1 but less than 5% of these older adults are likely to have received a CI System. 9 Many factors could potentially account for the low rate of CI use in older adults, such as a general perception of hearing loss being an inconsequential part of aging and poor awareness of and access to cochlear implantation. Additionally, there are concerns about whether older adults could practically benefit from CI on a daily basis. Older adults can consistently acquire improved speech perception scores after CI in the clinical setting, 10 but patterns of CI use by older adults has received little review. Previous studies have reported results only in small cohorts of older adults with limited durations of follow-up. [11][12][13][14][15][16][17][18] The purpose of our study was to investigate long-term rates of CI use in a consecutive case series of older adults (≥60 years) who received their first CI from 1999-2011. MATERIALS AND METHODS STUDY COHORTWe queried the Johns Hopkins Listening Center database to retrieve all patients ≥ 60 years who received a first CI from 1999 to June 2011 (n = 447). The purpose of this study was to investigate rates of CI use in older adults which is generally defined by the United Nations as adults ≥ 60 years. 33 Of these patients, we were able to successfully obtain follow-up information from the patient or a proxy respondent for 397 individuals (89%) from June to August 2012, and these individuals comprise our analytic cohort. Characteristics of "responders" (n = 397) and "non-responders" (n = 50) did not differ significantly by age of implantation, onset of hearing loss, side of implantation, or manufacturer (data not shown). Non-responders were more likely to have been implanted earlier in the study time period than responders (p < .001). Of the 50 non-responders, 27 (54%) had died based on Social Security Death Index records. For these deceased non-responders, we were unable to obtain proxy information on their CI use at the time of death due to unavailable contact information for surviving family members. This study was approved by Johns Hopkins Institutional Review Board. DATA COLLECTION ON CI USEAs part of a quality assurance initiative at the Johns Hopkins Listening Center, we contacted all CI patients and their families to survey their daily CI use. Postal and email survey...