Age-Related Hearing Loss: Presbycusis

Age-related hearing loss is one of the most dis-heartening of life’s experiences. Gradual loss of hearing is common as we age and is known as presbycusis. An estimated 25% of all people over the age of 65 have a decreased ability to hear and over the next 10 years that figure increases to around 75% of those aged 75 years or older.

What Causes Age-Related Hearing Loss?

Age-related hearing loss results from wear and tear of the ear over the years. Damage inflicted by noise is usually found in the inner ear. Many doctors and audiologists believe that heredity and persistent exposure to loud noises also contribute to hearing loss to some degree. Additionally, the build-up of ear wax can cause failure of the ear to carry sound as it was designed to do. Although doctors and hearing specialists can help you or a family member cope with hearing loss and improve what you hear, hearing loss itself is irreversible.

What Are The Signs And Symptoms Of Age-Related Hearing Loss?

Hearing loss is rarely a sudden occurrence, unless brought on by trauma. Over time, those who experience age-related hearing loss may see some or all of these signs:
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• Muffled speech
• Difficulty understanding what others are saying
• Difficulty understanding what is being said in a crowded room
• Need to have others to repeat what was said, or to speak with more clarity or volume
• Need to turn up the volume of the radio or television
• Abnormal withdrawal from conversations
• Avoidance of social settings

Understanding Hearing Loss

To understand hearing loss, you must first understand how we hear. The mechanisms that cause hearing are somewhat uncomplicated. Hearing takes place when sound waves travel through the structures inside the ear and are converted to nerve signals that can be recognised by the brain. There are three major areas that make up the ear – the outer ear, middle ear, and inner ear. Sound waves first pass through the outer ear and cause the eardrum to vibrate. The eardrum and the middle ear (which also contains three small bones known as the hammer, the anvil, and the stirrup) cause an amplification of the vibrations from the eardrum on their way to the inner ear. Once the vibrations reach the inner ear, they pass through fluid found in the cochlea, which is a small structure shaped much like a snail inside the inner ear. The cochlea are attached to nerve cells which, in turn, are covered with thousands of miniscule hairs that assist in the translation of the sound vibrations, turning them into electrical signals that are relayed to the brain. Different sounds are transmitted in different ways, allowing the brain to interpret a variety of messages through the ear.

Hearing Loss: Causes

While the buildup of earwax and earwax blockage can cause hearing loss in people of any age, most hearing loss is the result of damage to the delicate cochlea. The cochlea – or more specifically the tiny hairs in the cochlea – become bent or broken over time which can lead to degeneration of the nerve cells attached to the cochlea. When this happens, signals to the brain that normally occur when sound is transmitted may not be relayed as efficiently, which causes the perceived hearing loss.

Are You Or A Family Member At Risk For Hearing Loss?

The risk factors for hearing loss include:
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• Age
• Heredity
• Loud noises
• Medications like NSAIDS, aspirins, and loop diuretics
• Previous illnesses that are accompanied by high fever, such as meningitis

When To See A Doctor

If you are worried that you or a family member may be suffering from presbycusis, consult your family doctor in the first instance. Your hearing may have deteriorated if you are finding that it is difficult to understand parts of a conversation, or if sounds appear to be “muffled”. Your doctor will perform tests to establish if you have hearing loss and recommend a course of treatment which may be as simple as loosening the wax that has built up in your ear using special drops, fitting you with a hearing aid, or even implanting an electronic device known as a cochlear implant.