Objective: More than 40% of the population above 65 years of age suffers from hearing impairment and approximately 1% has a severe to profound loss, which cannot benefit from hearing aids. There is strong evidence that hearing loss in older adults is associated with both cognitive impairment and aging. Cochlear implantation improves auditory function and speech perception. The aim of this paper was to analyse outcomes and complications of cochlear implantation in elderly patients. Methods: We used a retrospective observational study on 30 hearing impaired patients over 65 years of age, unilaterally implanted for severe to profound bilateral sensorineural hearing loss. The results were statistically evaluated through the Student's t-test for paired data. Results: Thirty patients (16 males and 14 females) between 65 and 79 years of age (median = 70.5) underwent cochlear implantation in the last four years at our clinic. They were unilaterally implanted for profound hearing loss: the left side was implanted in 19 cases, the right side in 11 cases. Pre-operative pure tone average at 0.5, 1, 2, and 4 kHz improved from 111.8dB HL (± 17.8) without hearing aids to 42.6dB HL (± 10) with the cochlear implant during the post-operative period of follow-up; speech recognition threshold mean improved from 90dB SPL to 65dB SPL. No major complications were noticed during post-operative follow-ups. Discussion: Cochlear implantation is a safe procedure even among elderly patients who can significantly benefit from hearing threshold (p < 0.001) and speech perception (p < 0.01) improvements. Familial and professional supports are essential, as well as specific conditions, such as long time deprivation, entity and type of hearing loss, cognitive status, depression and anxiety, which can greatly influence the results of auditory rehabilitation and its perceived benefits. Conclusion: Cochlear implantation should be considered a safe and effective treatment of hearing loss even in older adults.

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During COVID-19 pandemic, protective measures such as social distancing and face masks posed a challenge in daily communication, in this context the elderly are one of the most at risk categories as widely exposed to hearing loss. This article focuses on how the COVID-19 pandemic affected verbal communication, especially on those people that even in normal conditions present an increased difficulty in speech perception. Special attention has been paid to hearing aids and cochlear implant users, these devices indeed can be affected by a speech intelligibility reduction and could be uncomfortable if used together with face masks. Possible alternatives and solutions will be proposed to reduce the negative impacts of face coverings on communication, to enhance speech intelligibility and to manage wearability of hearing rehabilitation devices.

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Epidemiological studies show increasing prevalence rates of cognitive decline and hearing loss with age, particularly after the age of 65 years. These conditions are reported to be associated, although conclusive evidence of causality and implications is lacking. Nevertheless, audiological and cognitive assessment among elderly people is a key target for comprehensive and multidisciplinary evaluation of the subject's frailty status. To evaluate the use of tools for identifying older adults at risk of hearing loss and cognitive decline and to compare skills and abilities in terms of hearing and cognitive performances between older adults and young subjects, we performed a prospective cross-sectional study using supraliminal auditory tests. The relationship between cognitive assessment results and audiometric results was investigated, and reference ranges for different ages or stages of disease were determined. Patients older than 65 years with different degrees of hearing function were enrolled. Each subject underwent an extensive audiological assessment, including tonal and speech audiometry, Italian Matrix Sentence Test, and speech audiometry with logatomes in quiet. Cognitive function was screened and then verified by experienced clinicians using the Montreal Cognitive Assessment Score, the Geriatric Depression Scale, and further investigations in some. One hundred twenty-three subjects were finally enrolled during 2016-2019: 103 were >65 years of age and 20 were younger participants (as controls). Cognitive functions showed a correlation with the audiological results in post-lingual hearing-impaired patients, in particular in those affected by slight to moderate hearing loss and aged more than 70 years. Audiological testing can thus be useful in clinical