Can You Hear Me Now?
What you should know about age-related hearing loss
Age-related hearing loss, known as presbycusis, is the gradual loss of hearing with increased age due to permanent changes of the inner ear and brain. It is one of the most common conditions affecting aging adults. Presbycusis can begin as early as the 30 and slowly decrease over time, often at such a gradual pace that one might not realize the magnitude of their hearing loss. While it is often accepted as part of the aging process, intervention is essential for a person’s overall health and wellbeing. Fortunately for our generation, our knowledge of ear mechanics combined with technological advances has brought hope to those who were once told they had “nerve deafness” and that nothing could be done.
There are many causes of hearing loss related to aging. Common chronic illnesses such as high blood pressure, diabetes and kidney disease are risk factors for progressive hearing loss. Genetics also play a huge role in age-related hearing loss as genes not only predispose us to some of the chronic illnesses listed above, but they also determine the strength of the internal structures of the inner ear. Although not directly related to age, prolonged noise exposure, or taking ototoxic medications such as powerful antibiotics or chemotherapy drugs can affect the inner ear’s sensory cells and will compound the effects of age-related hearing loss.
While many people think of hearing loss as the volume being turned down, the truth can be a lot more subtle. Not being able to understand what is being said when in a noisy place, or follow a conversation when many people are involved, are both signs of hearing loss. No longer noticing the birds or crickets sing or the blinker in the car clicking are also indications of hearing loss. Many people do not discover they have hearing loss until they seek medical help for tinnitus or ringing in the ears. While tinnitus is not always related to hearing loss, people who experience it often have hearing loss.
Age-related hearing loss can affect a person’s quality of life and safety in many ways. Not being able to follow a conversation with more than one person or in a noisy room are strong indicators of hearing loss, even though one may be able to communicate well in a quiet environment. Communication with family and friends becomes more difficult and takes away the enjoyment of visiting with others. This often leads to social withdrawal due to the frustration and anxiety of not being able to hear or understand speech.
Hearing loss can also cause other health issues like fatigue, stress, depression and balance issues. Untreated hearing loss can directly affect the safety of individuals who cannot hear the phone ringing, emergency sirens, smoke detectors and other important alerts. Mis-hearing instructions, advice and warnings from their doctors or others around them can lead to inappropriate responses to situations. Research has determined that even the early stages of untreated hearing loss can lead to a rewiring process of the brain in an attempt to correct the deficiencies experienced. This can lead to cognitive decline over time and put a person at greater risk for dementia.
Although age-related hearing loss cannot be prevented, research has shown that hearing aids and other types of amplification can often slow down or stop the hearing decline if programmed appropriately and used consistently. While early intervention is best, even later use of hearing aids can improve cognitive function as it gives a person more access to the world around them.
The best policy for identification and treatment of hearing loss is to locate your nearest audiologist or ENT physicians for further evaluation. Audiologists are, at minimum, master’s level health-care professionals who provide evidence-based assessment, diagnosis/treatment of hearing, balance, and other ear-related disorders. ENT physicians, or otolaryngologists, specialize in surgical and pharmacological intervention of ear pathologies. ENTs and audiologists often work together to make sure patients receive the highest level of care and to ensure that medically treatable conditions of a patient’s auditory and balance system receive appropriate medical management.
Once hearing loss has been identified, the right treatment plan must be put in place. Hearing aids, when appropriate, are a great tool to give personalized access to sound. Advances in technology have made them far better, especially for patients who were previously identified with “nerve deafness.”
Hearing aids, when programmed specifically for the wearer, can self-adjust for various listening situations, can connect to other devices such as cell phones and smart TVs, and may even provide tinnitus relief through auditory stimulation and built-in maskers. Many hearing aids are now even rechargeable.
While hearing aids are often a good intervention, they may not be the most appropriate option. Cochlear implants and osseointegrated bone-anchored devices are available to a far greater population than in years past. For some people with very minimal needs, a simple amplifier may suffice. To determine which intervention is best for one’s loss, lifestyle and budget, it is vital that one consult with a knowledgeable audiologist or ENT.
So many changes occur as we age, hearing not being the least of them, but changes in hearing are something that, with the right tools, don’t have to interfere with one living life to the fullest.
April Daniel is an instructor and clinical specialist of audiology at LSU Health Shreveport in the Department of Otolaryngology-Head & Neck Surgery. As a faculty member and instructor, she gives grand rounds presentations to otolaryngology faculty and residents. She supervises on-the-job training of doctor of audiology student clinicians from Louisiana Tech University and LSU Health New Orleans. April also provides diagnostic audiology services on an inpatient and outpatient basis at the Ochsner LSU Health Shreveport ENT Clinic. Call (318) 626-4110 for more information or to make an appointment.