Cochlear implant outcomes and quality of life in the elderly: Manchester experience over 13 years 1 Orabi, A.A.,* Mawman, D., † Al-Zoubi, F.,* Saeed, S.R.,* & Ramsden, R.T.* *University Department of Otolaryngology–Head and Neck Surgery, Manchester Royal Infirmary, and   Adult Cochlear Implant Programme, The University of Manchester, Manchester, UK Accepted 7 December 2005 Clin. Otolaryngol. 2006, 31, 116–122 Objectives: To objectively evaluate the clinical and func- tional outcomes of cochlear implantation in an elderly population. Design: Retrospective comparative study. Setting: Neurotology unit at Manchester Royal Infirmary, a supraregional tertiary referral centre in collaboration with Adult Cochlear Implant Programme at The Univer- sity of Manchester. Participants: All cochlear implant procedures (38) undertaken on post-lingually deafened elderly patients (age range at the time of implantation 65–80 years, n ¼ 34) in the period from 1989 to 2002. Main outcome measures: Medical and surgical outcomes. Audiological performance outcomes for isolated words, words in sentences in quiet and noise. Functional out- come measures used are self-reported measures of the social, psychological and emotional aspects of quality of life, and the differences between expectations for functional outcomes and the realization of functional outcomes. They included expectation profiles, Glasgow Benefit inventory (GBI) and Glasgow Health Status Inventory Questionnaire (GHSI). Results: There was statistically significant improvement post-implantation of both open and closed set test scores (P < 0.01). Eighty-two percentage of patients were com- pletely satisfied with their cochlear implants. Patients judged that implantation restored half the loss of quality of life that they had experienced as a result of severe- profound deafness with a highly significant (P < 0.001) improvement in overall quality of life after implantation. The commonest post-operative observation was transient mild pyrexia. Conclusions: The age of a cochlear implant candidate should not be a factor in the candidacy decision-making process. The quality of life of our elderly recipients was significantly improved after cochlear implant. In developed countries, the mean life expectancy now exceeds 75 years and is expected to rise in the 21st cen- tury. More than one-seventh of the UK population is older than 65 years (16%). 1 In this population, hearing impairment is the third most common chronic condition affecting non-institutionalized patients. This can contrib- ute to depression and a subjective decrease in well-being and social isolation. 2,3 Cochlear implantation is an inter- vention that may benefit individuals with a severe-to-pro- found sensori-neural hearing loss in which hearing aid trials are unsuccessful. Concerns about cochlear implant in the elderly include an increased risk of post-operative complications, co-existing medical and psychosocial problems, a long duration of deafness and diminished communication and learning abilities. 2,4–6 Previous adult studies have reported that effectiveness was not strongly associated with age at the time of implantation and that cochlear implant was effective for all age groups, including groups 60 years of age and older. 2,5,7,8 However, these studies have used only one or two outcomes parameters, i.e. audiological, medical/surgi- cal or functional, but not all of them. In Manchester, the provision of cochlear implants in the elderly (65 years and older at the time of implantation) was established in 1988. This study extends and complements an earlier report of a multicentre study by the UK Cochlear Implant Study Group, but presents additional outcome measures and a more extensive breakdown of the results from the Glasgow Benefit Inventory and the Glasgow Health Status Inventory. The aim of this study is to assess the benefits from cochlear implant in this age group of patients so that the purchasing authorities may recognize that Correspondence: S.R. Saeed, Consultant ENT and Skullbase Surgeon, Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL, UK, Tel.: +0161 276 4426, ext. 5705; fax: +0161 276 5003; e-mail: s.r.saeed@ btopenworld.com. 1 Part of this research was presented at 7th International Cochlear Implant Conference, Manchester, Sept 2002 and North of England Otolaryngology Society Meeting, Sheffield, March 2003. ORIGINAL ARTICLE 116 Ó 2006 The Authors. Journal compilation Ó 2006 Blackwell Publishing Limited, Clinical Otolaryngology, 31, 116–122