Age-related hearing impairment

• Article
• 2021-03-02

What is Age-Related Hearing Loss?

Age-related hearing loss (presbycusis) is the hearing loss that occurs gradually in most of us as we age. It is one of the most common conditions in older and older adults.

About one in three people in the United States between the ages of 65 and 74 has hearing loss, and nearly half of people over 75 have trouble hearing. If you have trouble hearing, it can be difficult to understand and follow a doctor's advice, respond to alerts, and hear telephones, doorbells, and smoke alarms. Hearing loss can also make it difficult to talk to family and friends, leading to a feeling of isolation.

Age-related hearing loss is most common in both ears and affects equally. Because the loss is gradual, if you have age-related hearing loss, you may not realize that you have lost some of your hearing loss.

There are many causes of age-related hearing loss. Usually it arises from changes in the inner ear as we age, but it can also be the result of changes in the middle ear or complex changes along the nerve pathways from the ear to the brain. Certain medical conditions and medications can also play a role.

How do we hear?

Hearing relies on a series of events that turn sound waves in the air into electrical signals. Your auditory nerve then carries these signals to your brain through a complex series of steps.

1. Sound waves enter the outer ear and travel through a narrow passage called the ear canal that leads to the eardrum.
2. The eardrum vibrates from the incoming sound waves and sends these vibrations to three small bones in the middle ear. These bones are called the hammer, anvil, and stirrup.
3. The bones in the middle ear couple the sound vibrations from the air to fluid vibrations in the cochlea of ​​the inner ear, which is shaped like a snail and filled with fluid. An elastic partition runs from the beginning to the end of the cochlea, splitting it into an upper and lower part. This partition is called the basilar membrane because it serves as the base, or ground floor, on which the main auditory structures sit.
4. As soon as the vibrations cause the fluid in the cochlea to ripple, a running wave forms along the basilar membrane. Hair cells - sensory cells that sit on top of the basilar membrane - ride the wave.
5. As the hair cells move up and down, microscopic hair-like protrusions (known as stereocilia) that sit on top of the hair cells collide with an overlying structure and bend. Bending opens pore-like channels located at the ends of the stereocilia. When that happens, chemicals flood into the cells and create an electrical signal.
6. The auditory nerve carries this electrical signal to the brain, turning it into a sound that we recognize and understand.

Why do we lose our hearing as we get older?

Many factors can contribute to hearing loss as you age. It can be difficult to distinguish age-related hearing loss from hearing loss that can occur for other reasons, such as prolonged exposure to noise.

Hearing loss caused by noise is caused by long-term exposure to sounds that are too loud or too long. This kind of exposure to noise can damage the sensory hair cells in your ear that allow you to hear. Once these hair cells are damaged, they will not grow back and your hearing will be reduced.

Conditions more common in older people, such as high blood pressure or diabetes, can contribute to hearing loss. Medicines that are toxic to the sensory cells in your ears (for example, some chemotherapy drugs) can also cause hearing loss.

In rare cases, age-related hearing loss can be caused by abnormalities in the outer or middle ear. Such abnormalities may include reduced function of the eardrum (eardrum) or reduced function of the three small bones in the middle ear that carry sound waves from the eardrum to the inner ear.

Most older people who experience hearing loss have a combination of both age-related hearing loss and noise-induced hearing loss.

Can I Prevent Age-Related Hearing Loss?

At present, scientists do not know how to prevent age-related hearing loss. However, you can protect yourself from noise-induced hearing loss by protecting your ears from loud noises that last too long. It is important to be aware of possible sources of harmful noise, such as loud music, firearms, snowmobiles, lawn mowers and leaf blowers. Avoiding loud noises, reducing the time you are exposed to loud noise, and protecting your ears with earplugs or earmuffs are simple things you can do to protect your hearing and the amount of hearing you could lose as you get older.

How do I know if I have a hearing problem?

Ask yourself the following questions. If you answer 'yes' to three or more of these questions, you may have a hearing problem and your hearing may need to be checked.

What if I have trouble hearing?

Hearing problems can be serious. The most important thing you can do if you think you have a hearing problem is to seek advice from a healthcare professional. There are different types of professionals who can help you. You may want to start with your primary care physician, an ENT specialist, an audiologist, or a hearing aid specialist. Each has a different type of training and expertise. Each can be an important part of your hearing care.

• An ENT (oh-toe-lair-in-GAH-luh-jist) is a physician who specializes in diagnosing and treating diseases of the ear, nose, throat, and neck. An ENT doctor, also called an ENT, will try to find out why you are having trouble hearing and offer treatment options. He or she can also refer you to another hearing care professional, an audiologist.
• An audiologist (aw-dee-AH-luh-jist) has undergone specialized training in identifying and measuring the type and degree of hearing loss. Some audiologists may be licensed to fit hearing aids.
• A hearing aid specialist is someone licensed by your country to perform and evaluate basic tests, provide advice, and fit and test hearing aids.

Which treatments and devices can help?

Your treatment will depend on the severity of your hearing loss, so some treatments will work better for you than others. There are a number of devices and aids that can help you hear better when you have hearing loss. These are the most common:

• Hearing aids are electronic instruments that
  
  
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