It is true that hearing loss occurs in most of us as we grow older. Age-related hearing loss or presbycusis is quite a common issue these days that affects older and elderly adults, and sadly in most cases, it is unpreventable. You can only try to stay healthy as long as possible.

In the US, approximately 1 in 3 people in between the age group of 65 and 74 have hearing loss, and about half of those who are of 75 years and above have difficulty hearing. Hearing impairment is ranked third in the list of chronic health conditions which affect people belonging to the age group of 65 and above.

According to the World Health Organization (WHO) estimates, within the year 2025 there will be about 1.2 billion people over 60 years of age worldwide, with more than 500 million individuals who will suffer a significant hearing impairment from presbycusis, also known as an age-related hearing loss.

Presbycusis has a major impact on the quality of life of a person and is related to a significant reduction in his or her communication skills. It also affects the psycho-social aspects of an individual, such as inducing progressive isolation, possibly exacerbating anxiety-depressive status and/or accentuating possible cognitive deficits.

 

Classifications of Presbycusis

Schuknecht, et al. 1993 categorised presbycusis into four types based on pathology and audiometric findings - sensory, neural, conductive, and metabolic (strial).

  • Sensory presbycusis is defined as epithelial atrophy and loss of sensory hair cells as well as the supporting cells of the organ of Corti, which arise from the base and progress towards the apex. In this type of presbycusis, the slope of the audiogram (a graph which shows the results of the pure-tone hearing test) occurs in the high frequencies, therefore, the speech discrimination is preserved.

  • Neural presbycusis results from nerve cells atrophy in the cochlea and central neural pathway. Atrophy occurs throughout the cochlea with no sheer or dangerous drops in the high-frequency threshold in the audiogram. The speech discrimination decreases severely even before hearing loss is recorded.

  • Conductive or mechanical type arises from thickening and secondary stiffening of the basilar membrane of the cochlea with a gradual sloping high-frequency sensorineural hearing loss. Speech discrimination is preserved in this type of presbycusis.

  • Atrophy of stria vascularis results in metabolic or strial presbycusis which affect the entire cochlea and show a flat curve in the audiogram.

 

Why Do People Get Hearing Loss as They Age?

There are many factors which contribute to hearing loss as you start ageing. Although it is quite difficult to distinguish age-related hearing loss or presbycusis from other factors that might be responsible for it, yet let us take a look at the possible reasons that might cause hearing loss as you age.

  • Noise-induced hearing loss (NIHL) - It is caused either by long term exposure to sounds which are either too loud or which last for too long. This exposure causes damage to the hair cells present inside the cochlea of the inner ear, which are responsible for converting sound waves into neural signals, thus making them ready to be sent to the brain via the auditory nerve. Once damaged, these hair cells can never grow or regenerate. They are gone forever! Therefore the term ‘permanent hearing loss’!

  • High blood pressure or hypertension - The link between hearing loss and high blood pressure is pretty simple. When your blood pressure is high, your blood vessels are damaged, which is not limited to just one area in your whole circulatory system and thus includes your ears as well and hampering proper blood circulation. In simple words, if the blood circulation in your ears is affected, your ears won’t work well and thus leading to hearing loss problems.

  • Diabetes - High blood glucose levels can damage the small blood vessels in the inner ear, thus affecting your hearing abilities.

  • Ototoxic medications - Medications, like chemotherapy drugs are toxic to the sensory cells of your ears, thus affecting their functioning and causing hearing loss.

  • Genetics - Yes your parents hearing health matters! Some diseases like Otosclerosis, Usher Syndrome, Pendred Syndrome, which cause hearing loss are hereditary.

Apart from these common causes of age-related hearing loss, there can be cases like sudden damage to the internal structure of the outer or the middle ear due to various reasons like a serious injury. However, these conditions are very less as far as presbycusis is concerned.

Studies show that most of the older people who acquire a hearing loss have a combination of both age-related hearing loss and noise-induced hearing loss.

 

Age-related hearing loss is a gradual process and often occurs in both the ears, affecting them equally. And the sad part is that in most of the cases an individual may not even realise that he or she is suffering from age-related hearing loss and that he or she has lost some of his or her hearing ability. And this realisation is generally late until there are some other damages associated with it. Of course, there are so many hearing loss treatment options, the most common being hearing aids, but you just need to take that action.

But the question arises, ‘How would you know that you have hearing loss?’

There are many signs which tell you that its time that you take serious action. If you are still confused about whether you are suffering from hearing loss, here’s a simple checklist for you. Ask yourself and try to answer all of them. If you answer with an ‘Yes’ to three or more of these questions, then it’s a good chance that you are having some degree of hearing loss.

  • Do you feel embarrassed while meeting new people?

  • Do you feel that others are mumbling?

  • Do you often ask people to repeat themselves?

  • Do you often find it difficult to understand what others are trying to convey and hence feel frustrated?

  • Do you face problems while listening to the radio or the TV and hence end up raising up the volume which is too loud for others?

  • Do you have a hard time hearing while at the movies or at the theatre?

  • Do you have trouble hearing when you are at a restaurant with your family and friends?

  • Do you face difficulties in understanding speech in a noisy area?

  • Do you have difficulties in differentiating between ‘s’ and ‘th’ sounds?

  • Do you have difficulty understanding what your co-workers, clients or customers are trying to say?

  • Do you often end up arguing with your family members because you are unable to understand them?

  • Do you often avoid attending social gatherings?

  • Do you often avoid making phone calls or even receiving them, thus end up giving excuses via text messages like ‘I was not carrying my phone’ or ‘My phone was silent’, etc.?

  • Do you have a sensation of ringing in the ears or tinnitus?

 

Now that you know that you might have hearing loss (and that’s why you are reading this blog), head on to know how to fight against it.

 

How to Fight Against It?

Do not panic! The first and foremost thing that you should do is to get up from your chair at the corner of your room and step outside your house! Visit your nearest hearing clinic or a professional Audiologist and get your hearing tested. An ideal Audiologist is supposed to test your hearing thoroughly, provide you with an audiogram report and explain you the test results in details. Depending on your test results - that is the type and the intensity of your hearing loss, your Audiologist will suggest you the hearing aids (devices that are worn in the ear to enable you to hear better) which would best suit your hearing needs as well as your personal preferences.

A good Audiologist will also do a test and trial with a few hearing aids of various types and determine with which device are you responding the best. Also, he or she would also help you out in the days to come if you face any problems with your device in the future - such as reprogramming and fitting.

Keep in mind that hearing aids are not like eyeglasses, which would give you a clear vision immediately after wearing them. Hearing aids don’t just work that way. It takes time for your brain to adjust to this new hearing world which it was missing for all these days because of your untreated hearing loss.

If, however, you find that your hearing aids are not giving you many benefits even after using them for a long time, then you need to consult your Audiologist immediately. It might be that your hearing loss is so severe such as in case of a severe to profound degree of sensorineural hearing loss, then your Audiologist might recommend you to go for a cochlear implant, an electrical device that is surgically implanted inside your ear and in which you would get a permanent hearing solution, and unlike hearing aids you don’t need to change the device after using it for some years. A cochlear implant only needs to be updated from time to time.

Apart from hearing aids and cochlear implants, there are other devices as well such as assistive listening devices which include telephone and cell phone amplifying devices, smartphone apps to enhance the listening experience and closed-circuit systems like hearing loop systems (example microphones) which are found in places like a theatre, a temple or at some other public event.

Lip reading or speech reading is another option to assist hearing impaired people and to help them understand better what others are trying to convey. Lip reading involves paying close attention to lip movement as well as other body language movements and gestures.

 

The best way to avoid hearing loss problems is to prevent it. Because prevention is always better than cure!

 

How Can I Prevent Age-Related Hearing Loss?

Although at present, proper preventive measures of age-related hearing loss have not been found, yet there are certain ways following which can help you prevent hearing loss due to ageing. These are as follows -

  • Protect your ears and avoid being overexposed to loud sounds. In this way, you can prevent noise-induced hearing loss. Use earplugs or other protective wearables whenever you are near a source of some loud sound.

  • Avoid the intake of ototoxic medications until and unless you have no other option.

  • Take care of your high blood pressure and diabetic problems by consulting a good health professional.

  • Get your ears checked from time to time to prevent any serious hearing loss problems in the future.

  • Avoid smoking and drinking.

So stay healthy and hear better for as long as you can!