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The Olive Branch

Presbycusis: Everything You Need to Know

middle aged woman with presbycusis


Did you know that aging is a significant cause of hearing loss, or presbycusis? 


It might surprise you to learn that age-related hearing loss is one of the most common conditions affecting older and elderly adults.


This article explains everything you need to know about presbycusis.

What is Presbycusis? 


Most people experience a gradual loss of hearing as they get older. This is known as presbycusis but is sometimes referred to as age-related hearing loss.


Presbycusis is a very common condition, affecting around 30 - 35 percent of adults age 65 and older in the United States. As you get older, your risk of experiencing hearing loss increases. This is reflected in the data. An estimated 40 - 50 percent of people aged 75 and older have some degree of hearing loss. Unfortunately, as the process of hearing loss can be as gradual as aging, it can be difficult to realize that you even have an issue until your hearing is severely diminished.


So, what characterizes this loss? If you have presbycusis you might experience hearing loss for high-pitched sounds (such as bird tweets, a child’s voice, or a text message notification) but not low-pitched sounds (like a car or a dog’s growl). This is frequently the case with presbycusis and if you can relate, you’re certainly not alone.


Presbycusis is caused by the natural aging process, but still, why does it happen? The inner ear changes as you age which can result in presbycusis. However this being said, changes in the middle ear and along the nerve pathways leading to the brain can also result in the disorder. It’s good to be aware that some pre-existing medical conditions and (ototoxic) medications may also play a role in the development of the condition if they affect your delicate ear structures.


As presbycusis is not a result of something such as an infection or an ear wax build-up (which often affects only one ear) - it is a result of a long aging process, it often occurs in equal severity in both ears. 


How Does Presbycusis Affect Someone? 


Although hearing loss is not generally thought of as a serious ‘life-threatening’ condition, it can certainly be life-limiting for the sufferer. 


Hearing loss makes everyday life much harder, and simple tasks can all of a sudden feel nearly unmanageable. If you can’t easily hear your phone, doorbells, smoke alarms, the radio, TV, or the cashier at the checkout, every connection you experience with the outside world can feel like you’re wading through water. This is all before acknowledging the impact hearing loss can have on your interactions with family and friends. If you can’t hear during conversations, you’re less inclined to take part. And if you stop socializing, this can quickly lead to feelings of isolation and depression.


Age-related hearing loss can be different for everyone it affects. Your loss could be mild, moderate, or severe, and one of your ears might feel better or worse than the other. If you also have a pre-existing condition such as impaired vision, you might feel more hindered in your daily life in comparison to other people who are just dealing with their hearing.


What Are the Symptoms of Presbycusis? 


Symptoms of presbycusis include:


  • Sounds often seem less clear and lower in volume
  • Difficulty in hearing and understanding speech 
  • Other’s speech sounds mumbled or slurred
  • High-pitched sounds such as “s” and “th” are difficult to hear and tell apart
  • Conversations are difficult to understand (this is worse when there is background noise)
  • A man’s voice is easier to hear than the higher pitches of a woman’s or child’s voice
  • Some sounds are overly loud
  • Tinnitus (ringing in the ears)

This list is not exhaustive and other health problems can lead to presbycusis. 

How Can a Physician Diagnose Presbycusis? 


If you are experiencing what feels like hearing loss, it’s crucial to see your physician as soon as possible for a hearing test. If you do have hearing loss, it needs to be treated or else it could exacerbate the development of balance issues and memory problems.


If a basic hearing test from a primary care professional indicates that you have hearing loss, you might be referred to an otolaryngologist (specialized in diagnosing and treating diseases of the ear, nose, throat, and neck), an audiologist (able to identify and measure the type and degree of hearing loss), or a hearing aid specialist according to the expertise and training required.


Basic diagnostic procedures include using an otoscope to check for a blockage in the outer ear canal, damage to the eardrum, impacted earwax, and inflammation or infection.


An audiogram test conducted by an audiologist will be particularly useful in determining the type and severity of your hearing loss. This in turn helps to inform your treatment options.


What Causes Presbycusis? 


Presbycusis is usually a sensorineural hearing disorder, and this type of hearing loss is commonly caused by disorders of (and gradual changes within) the inner ear or auditory nerve.


Alongside aging, these factors can increase your risk and the severity of hearing loss:


  • Long-term exposure to loud noise 
  • Inherited factors
  • Having health conditions such as heart disease or diabetes (as these cause changes in the blood supply to the ear)
  • Taking some medicines, such as aspirin, chemotherapy medicines, and certain antibiotics
  • Infections in the ear
  • Smoking

While we’re talking about causes, it’s important to acknowledge that most older people who experience hearing loss actually have a combination of both age-related hearing loss and noise-induced hearing loss. In fact, it’s often very difficult to figure out which is the main cause of your hearing issues.


If you have lived your life working in a noisy office, on a construction site, as a touring musician, attending loud music venues, or hunting as a hobby (without sufficient ear protection) this might have caused or contributed towards a sensorineural hearing loss (a loss of hair cells or sensory receptors in the inner ear). Any noise (that is too loud or long-lasting) that you have been exposed to long term during a period of time in your life might have had a role to play in your hearing loss now.


On the other hand, presbycusis can also be a conductive hearing disorder caused by abnormalities of the outer ear and/or middle ear. Possible abnormalities include reduced function of the tympanic membrane (the eardrum) or of the three tiny bones in the middle ear responsible for carrying sound waves from the tympanic membrane to the inner ear.

How Can You Treat Age-Related Hearing Loss? 


Age-related hearing loss can’t be treated. However, hearing aids, assistive devices (such as telephone amplifiers, spoken words to text technology, and apps), training in speech reading, and methods to prevent too much wax in the outer ear can help improve your experience of hearing loss. 


Hearing aid styles include Behind-the-ear (BTE), Mini BTE, In-the-ear (ITE), In-the-canal (ITC), and Completely-in-canal (CIC). Each has its advantages and disadvantages.


Ultimately, your treatment will depend on the severity of your hearing loss and will be chosen with the help of your audiologist.


Can You Prevent Presbycusis?


Although you can’t stop the aging process (as much as we’d all like to), you can prevent age-related hearing loss by protecting your hearing as much as you can throughout your life.


Avoid risk factors such as short and sharp loud noises as well as prolonged exposure to loud noise. Remember, noise damage is permanent damage. Wear earplugs or earmuffs during loud leisure activities (such as concerts and hunting) or if your work environment is noisy. Also, try to give up smoking and adopt a healthy, active lifestyle. This will help to limit your hearing loss during old age.


If you encounter health issues affecting the ear such as ear infections, get quick treatment to prevent further damage from occurring. If you have health conditions such as heart disease or diabetes, stay on top of your treatment.


To learn more about age-related hearing loss and your treatment options, check out our other blog articles.

 

The information in this guide has been written using the following reliable sources:

 

https://www.nidcd.nih.gov/sites/default/files/Content%20Images/presbycusis.pdf

 

https://www.nidcd.nih.gov/health/age-related-hearing-loss

 

https://www.cedars-sinai.org/health-library/diseases-and-conditions/a/age-related-hearing-loss-presbycusis.html



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