Elderly with Hearing Loss Turning to Cochlear Implants

Cochlear implants have proven an effective but controversial means of restoring hearing in children. NPR science correspondent Joseph Shapiro reports that the implants are now gaining popularity among elderly people who suffer from hearing loss.

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MADELEINE BRAND, host:

This is DAY TO DAY. I'm Madeleine Brand.

In a moment, an update on the US government's war on drugs in Colombia. But, first, a new report says a device called a Cochlear implant can help even the oldest people who've lost hearing. The device is best known for helping thousands of deaf children hear. And while there's sometimes been controversy over the implant in children, the use among older people is growing. NPR's Joseph Shapiro reports.

JOSEPH SHAPIRO reporting:

Beatrice Cornelius is 75 and busy. She recently moved into a just-built apartment with white rugs and white couches. On her dining room table there's a gold medal in a small, blue box. The archbishop of Washington gave it to her last week to recognize all of her volunteer work.

Ms. BEATRICE CORNELIUS: I serve communion to the parishioners and take communion to the home-bound. I also volunteer at the shrine at the information desk.

SHAPIRO: That's the Basilica of the National Shrine of the Immaculate Conception in Washington, one of the largest Catholic churches in the world.

Ms. CORNELIUS: And they want me to give tours, some of the ladies. I said, `Well, you know, people are walking with you and they're asking questions, and I cannot hear them behind me.' They say, `Well, we know that you know what to say.'

SHAPIRO: Cornelius is deaf. Part of her hearing's been restored, thanks to the small electronic device surgically implanted behind her ear. It's a Cochlear implant, a device that electrically stimulates the hearing nerve.

You have something behind the ear now?

Ms. CORNELIUS: No, it's implanted. Computerized material is implanted, and I have a processor, which processes the information as it goes in.

SHAPIRO: She shows the small computer process that's clipped to her waistband. It's about the size of a cell phone and connects to a thin, black wire that reaches to behind her left ear.

Ms. CORNELIUS: And now if I take this off, I would not hear anything, not a fire alarm, not fire trucks, anything.

SHAPIRO: With the device she can talk on the telephone. Face to face she has conversations, although she still relies on lip-reading. She can even enjoy music, although she says she hears familiar music best.

Ms. CORNELIUS: I have a tape in my car, "How Great Thou Art," "Amazing Grace," and I pretty much know the words, and so that I can manage pretty well.

SHAPIRO: There's been controversy around Cochlear implants, especially when they were first used in children born deaf. Some deaf people objected angrily that children would end up with imperfect hearing and be cut off from the unique culture in sign language of other people born deaf. There was controversy, too, over giving implants to older people, questions over whether it was worth the risk of having surgery and and whether the devices worked well enough for older people. Many doctors thought the answer was no. Sig Soli says that's changing.

Dr. SIG SOLI (House Ear Institute): The benefits of the Cochlear implant have improved as the technology has improved and as our understanding of how to rehabilitate people has improved.

SHAPIRO: Soli's a researcher at the House Ear Institute in Los Angeles.

Dr. SOLI: So that means the amount of benefit that a person can receive during the remainder of their life after a Cochlear implant is larger now than it was before.

SHAPIRO: Medicare doesn't pay for hearing aids, but it does pay for Cochlear implants. The device itself costs about $25,000; the surgery is about $10,000. Insurers have wanted to know more about whether implants for the elderly are worth the money, so Dr. John Niparko went to find out. He runs the hearing care program at Johns Hopkins Hospital. Niparko studied 258 people 65 and older to see how well they could hear with implants. Then he compared them to younger patients and found the older ones did...

Dr. JOHN NIPARKO (Johns Hopkins Hospital): ...surprisingly well. What we found was that age, per se, was a very poor predictor of how someone would perform with a Cochlear implant.

SHAPIRO: The thing that mattered most wasn't how old the patient was but how long they'd been deaf before getting the implant.

Dr. NIPARKO: The duration of deafness was a much more important predictor of how the performance level would play out over time.

SHAPIRO: Niparko's research appears in the current issue of the Archives of Otolaryngology. He says even some of the oldest old are now getting implants.

Dr. NIPARKO: I don't know what the world's record is. I know there are several patients on the East Coast who've received the implant in their early 90s. In one case, I know that a grandparent heard three generations all at the same time for the first time.

SHAPIRO: More older Americans are having trouble hearing. Cochlear implants will be an option for only about 5 percent of them. To be eligible, an older person must hear less than 40 percent of what's said, even with powerful hearing aids. Joseph Shapiro, NPR News.

BRAND: More coming up on DAY TO DAY from NPR News.

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