Impact of unilateral cochlear implants on health, functionality, and quality of life in people over 60 years of age.

OBJECTIVE

To evaluate the impact of unilateral cochlear implantation (CI) on quality of life and audiological, functional and psycho-emotional outcomes in a cohort of individuals aged 60 years or older, and to identify predictors of these outcomes.

METHODS

A single-center, retrospective observational cohort study was conducted. The primary endpoint was the change in health-related quality of life, measured by the Health Utilities Index-Mark 3 (HUI-3). Audiological outcomes, quality of life (GBI, NCIQ, HISQUI-19), functionality (IADL, Barthel), and psycho-emotional status (GDS-15, DJGLS, DAS) were cross-sectionally assessed using validated instruments. Multivariate linear regression models were used to identify predictors.

RESULTS

From a target population of 278 individuals, a final sample of 71 was included (31.1% participation rate). The intervention yielded statistically significant and clinically relevant improvements in the primary endpoint of quality of life (mean HUI-3 gain: 0.14; p < 0.001) and in audiological outcomes (mean PTA gain: 63.6 dB; p < 0.001 and in intelligibility: 53%; p = 0.033). Regression analyses identified that higher perceived sound quality (HISQUI-19) was associated with higher HUI-3, higher apathy (DAS) with lower GBI, and greater functional independence (Barthel) with better PTA.

CONCLUSIONS

Unilateral CI is highly effective in older adults, but the perceived benefit is strongly modulated by psycho-emotional factors and the subjective experience of sound, beyond objective audiological gain. Apathy and poor perceived sound quality emerge as key barriers to success. A nursing care model that systematically integrates psycho-emotional assessment and expectation management into the preoperative phase is needed to maximize the benefits of this technology.