In our noisy society, about 36 million adults have some degree of hearing loss. A third of Americans (ages 65 to 74) and almost half of those 75 and older develop hearing loss, according to the National Institutes of Health.
Although there are many types and causes of hearing loss, presbycusis is the gradual hearing loss we associate with the aging process. “Presbycusis is defined as the change that occurs in the inner ear with increasing age that leads to loss of cells in the hearing mechanism,” explains Dr. Milta Little, a SLUCare physician specializing in geriatric medicine.
Age-related hearing loss does seem to run in families, but noise exposure is a major contributor. “There are lots of hearing losses that have a genetic base that may show up in middle age or later on,” says Dr. Robert Mareing, a clinical audiologist with Washington University Physicians. “Early noise exposure may be compounded on some general changes that occur—usually in the higher pitches—as a result of aging.”
Because higher frequencies tend to be lost first, female voices and certain sounds in speech become more difficult to hear. This makes an inability to clearly understand conversation one of the first signs of age-related hearing loss. The need to increase volume on television and radio, and to ask people to repeat themselves—especially if there is background noise—are telltale signs. Instead of suffering through the frustration of hearing loss, experts urge people to see their primary-care physician and ask about hearing assessment.
“The cause of hearing loss can be determined through a good medical history, a physical exam and a hearing test by a hearing specialist, an audiologist,” Little says. “The audiologist uses special tests to help distinguish problems in the nerve cells as opposed to the canal or ear bones. An audiologist will also be able to determine which hearing aid will work best for an individual person.”
Mareing conducts hearing evaluations that include testing with earphones to determine which tones are heard at a variety of frequencies along with ‘word testing.’ “We see how loud we have to make speech for people to begin hearing it,” he says. “Another part of the word testing measures how clearly people can hear speech at comfortable levels.”
Little notes that a thorough exam also checks for reversible causes of hearing loss, such as excessive ear-wax buildup. “Some medications also can lead to hearing loss and tinnitus (ringing in the ears), which may be reversible if the medicines are stopped,” she says. “In rare cases, brain tumors or excessive fluid in the ear may first present as hearing loss and hearing may be restored with proper treatment.”
In many cases, presbycusis can be successfully treated with hearing aids, which are now available in a variety of sizes and with advanced features, such as bluetooth technology. “The low-tech strategies to improve communication during conversation are still recommended, as well,” Little says. “These strategies include sitting face-to-face, lowering one's voice and talking slowly.”
Of course, prevention by protecting oneself from excessively loud sounds is the best strategy for younger people. Proper hearing protection for those who work in noisy environments or are exposed to sounds such as lawn mowers, fireworks or loud music can help prevent hearing loss later in life.
“Untreated hearing loss can lead to social isolation, depression, anxiety and breakdown in relationships,” Little notes. “It’s very important to talk with your doctor if you or a loved one has noticed any difficulty in hearing. The earlier hearing loss is treated, the better.”