Cochlear implants, devices that directly stimulate the auditory nerve, are increasingly being used to help older adults with severe or profound hearing loss. While traditionally associated with children, experts say age should not be a barrier to considering this treatment.
According to the National Institute on Deafness and Other Communication Disorders (NIDCD), more than half of Americans over age 75 experience hearing loss. Hearing aids are often effective for many seniors, but those with more advanced hearing loss may find them insufficient.
Cochlear implants work by bypassing damaged inner ear cells and sending electrical signals via electrodes to the brain, which can improve speech perception. "As you lose your hearing, your brain is changing, adapting to the limited information you’re getting," said Dr. Buchman. "What you’re used to is degraded. By three months, the vast majority of people are having good speech understanding and awareness. The brain takes the information and clarifies it."
Recent research has shown that adults benefit from cochlear implants as much as children do. In fact, data from manufacturer Cochlear indicates that the average recipient age is 65. A 2020 global consensus report from 31 hearing experts found that age should not influence a decision about receiving an implant.
Eligibility guidelines generally include having moderate to profound sensorineural hearing loss in both ears and experiencing limited benefit from hearing aids—defined clinically as less than 50% sentence recognition in the ear considered for implantation—and being healthy enough for surgery.
Medicare covers cochlear implants if patients recognize sentences with their hearing aids only 40 percent of the time or less; those scoring between 40 and 60 percent may qualify if enrolled in a clinical trial. Medicaid coverage varies by state, and many private insurers also provide benefits.
The surgical procedure is performed by specialists known as neurotologists or otologists after referral from a primary care provider. Most patients start with one implant in their worse-hearing ear but may later receive another or use a bimodal approach combining an implant and a traditional aid.
Following surgery, recipients typically attend several programming sessions and auditory rehabilitation appointments—often six to ten weekly—to adjust their device settings and practice understanding sounds. Many report improvements in speech comprehension, awareness of everyday noises like footsteps or ringing phones, easier conversations with familiar voices, better phone use, and greater enjoyment of television or music.
Adjusting to a cochlear implant can take time as users adapt to new sound input; however, most adults notice steady progress within months after activation. Specialists recommend discussing realistic expectations with healthcare providers before proceeding.
"It's important to remember that you’re never too old to take steps toward better hearing," according to experts cited in recent guidance on treatment options for older adults who no longer find sufficient clarity from traditional aids.
For further details about how cochlear implants differ from hearing aids or what happens during surgery, additional resources are available through healthcare providers specializing in ear disorders.
