Age-Related Hearing Loss

By: Dr. Lusine Mamikonyan

What is age-related hearing loss?

Age-related hearing loss, also known as presbycusis, is a gradual hearing loss in both ears affecting the elderly population. The term presbycusis originates from the Greek words “old hearing.” Worldwide, it is the most common cause of hearing impairment, as one in three adults over 60 suffers from this condition, while one in two adults over 85 has this condition. According to the World Health Organization, it is estimated that more than 500 million people in the world older than age 60 will be diagnosed with age-related hearing loss by 2025.

What causes age-related hearing loss?

Age-related hearing loss mainly develops due to inner ear injury, where the cochlea is located. Age-related changes affect the cochlear hair cells that convert the sound vibration into a nerve impulse that travels to the brain; thus, sound perception occurs.

Presbycusis is a multifactorial disorder. Various factors affecting the hair cells have been proposed to lead to hearing impairment, such as genetic factors, ototoxic medications, noise exposure, and comorbidities. Recent evidence suggests the presence of specific genes that increase hearing loss susceptibility among the carriers. Hearing injury can be a side effect of certain medications, including chemotherapeutic agents, loop diuretics, aminoglycosides, and NSAIDs. Various disorders such as hypertension and diabetes that reduce the blood supply to the inner ear can also affect hearing.

What are the symptoms of age-related hearing loss?

People with presbycusis present with slowly progressing hearing loss that equally impairs bilateral hearing. In some cases, it can be initially noticed by their family members or friends. Patients complain of poor hearing, especially with female and children voices, as the perception of the high-pitched sounds is affected first. They have difficulties while conversing with more than one person or when there is background noise. Sometimes, hearing loss can be accompanied by tinnitus or a ringing sound in the ears. In addition, hearing impairment can affect the patient’s social life, as they might avoid conversations and become isolated. All these factors can be associated with increased depression levels and decreased quality of life among the elderly population.

How is age-related hearing loss diagnosed?

Patients should seek an appointment with their primary care physician if they are experiencing hearing loss. If needed, the physician will refer the patient to an audiologist to further evaluate the hearing impairment. The audiologist will conduct a hearing test called pure tone audiometry to identify the presence of hearing loss, its degree, and its type. Sometimes, there might be a need for additional laboratory tests, such as blood glucose and lipid profile tests, to detect diseases associated with hearing loss.

What is the treatment plan for age-related hearing loss?

The management plan is based on the severity of the hearing loss. Most patients will significantly benefit from hearing aids. These devices enhance hearing by amplifying sounds and making them audible for the users. Hearing aids are game-changers as they improve patients’ communication with their loved ones and the quality of life. People with severe bilateral hearing loss, when the hearing aids are not effective, are offered cochlear implants, which are surgically inserted in the inner ear. The journey to improve hearing during presbycusis is challenging and requires significant effort, continuous care, and collaboration with an audiologist.