Difficulty hearing is commonly associated with older people.
Although age-related hearing loss is natural, many common causes can exacerbate hearing loss and cause it to become more severe.
Together, we’ll talk about what age-related hearing loss is, how you can avoid it for as long as possible, and what you can do to prevent it proactively. First, let’s look at how our ears hear sound.
How Do Our Ears Hear?
The ears are extremely complex, and three distinctive parts work together to interpret the sound waves in our environment into the sounds we hear.
There are three specific regions in the ear.
- Outer Ear. The visible part of the ear is the pinna. Together with the ear canal, these structures make up the outer ear.
- Middle Ear. The middle ear includes the eardrum and three small bones called the malleus, incus, and stapes.
- Inner Ear. The inner ear includes the cochlea, semicircular canals, and the vestibular and auditory nerves.
These three parts collect sound waves and convert them into electric signals.
Sound waves are collected by the outer ear and travel down the ear canal to the bones in the middle ear to the eardrum.
The eardrum vibrates against the three bones of the middle ear, which amplify the sound waves and send them to the cochlea, a fluid-filled structure that resembles a swirled snail shell.
The cochlea has two parts by the basilar membrane. Special cells that are tiny hairs sit atop the basilar membrane.
As the fluid inside the cochlea moves from the vibrations of the three bones of the middle ear, the tiny hairs begin to move, too. They trigger a rush of chemicals into neighboring cells, turning the sound waves into electrical signals.
The auditory nerve collects these electric signals and sends the signals to the brain. The brain then interprets what we hear as sound. When these structures are damaged, you may lose a portion of your hearing.
What Is Age-Related Hearing Loss?
Age-related hearing loss, also known as presbycusis, is a slow, progressive, bilateral hearing loss.
This means it is hearing loss that affects both of the ears and happens over time, usually decades. It affects approximately 30 percent of adults over the age of 65.
Because this type of hearing loss happens slowly, it may be hard to notice until you suddenly become aware of the inability to hear high-pitched or high-frequency noises.
You may begin to notice you can’t hear your doorbell or that you are unable to hear your microwave “ding,” indicating your food is ready.
What Causes Age-Related Hearing Loss?
Some hearing loss with age is normal. Changes in the ears due to the natural aging process can affect how we hear.
As the structures of the ear age, they may not function as well as they used to, resulting in hearing loss.
There may be other causes of presbycusis.
Loss of Sensory Hair Cells
The special sensory cells in our ears, for instance, are limited. Most of us are born with approximately 15,000 of them.
When they are damaged or destroyed, they do not regenerate. It’s easy to imagine that, throughout one’s life, some of these cells would be lost, thus causing partial or full hearing loss.
These hairs can become damaged due to impulse noises (exposure to loud noise on one occasion only) or long-term exposure.
Long-Term Exposure to Loud Noise
Over time, continued exposure to loud noise can damage your hearing.
Noise over 70 decibels is considered unsafe for your ears and could damage your hearing in the long run. If you work at a job with this level of noise daily, you are more susceptible to developing presbycusis sooner.
Family History of Hearing Loss
Some of your hearing loss may be related to your DNA. Babies born with deafness, for instance, may have inherited that mutation due to their genetics.
In terms of age-related hearing loss, if one or both of your parents lost their hearing early, it is more likely that you will lose your hearing sooner, too.
Diseases
Some illnesses can affect your hearing. Diabetes, for instance, makes a person twice as likely to experience hearing loss than someone who does not have diabetes.
Diabetes is linked with nerve damage, which can damage nerves in your ear responsible for helping you hear.
Heart disease and high blood pressure are also risk factors for hearing problems.
Heart disease, high blood pressure, and diabetes can cause damage to blood vessels and can damage the tiny blood vessels in the ears leading to hearing impairment.
If you have any of these medical conditions, talk to your primary care physician about the risk of associated hearing loss.
Autoimmune disorders, Ménière's disease, and otosclerosis (a disease of the middle ear) are reasons you might develop hearing loss and why age-related hearing loss may happen more quickly.
Side Effects of Medication
Some medications may cause temporary hearing loss or cause age-related hearing loss to become more severe.
Over-the-counter pain relievers may cause tinnitus or hearing loss, but usually only after prolonged periods of exposure.
Other prescription medications may come with a warning of potential side effects that include hearing loss. It’s important to discuss your health conditions with your doctor and determine if the medications you are taking may affect your hearing.
Infections
Serious, recurrent ear infections, chicken pox, measles, and mumps may cause hearing loss.Because of the availability of vaccines and antibiotics in the United States, these diseases are rare, and developing hearing loss as a side effect is even more unlikely.
If you have an ear infection, ensure you receive treatment immediately. Your doctor may suggest other preventive treatment options if you develop recurrent ear infections.
Symptoms of Age-Related Hearing Loss
One of the most evident symptoms of hearing loss is the inability to hear like you once could.
However, because age-related hearing loss is progressive, it might be harder to detect. Frequent symptoms include:
- Not being able to hear other people speak as clearly. Voices may begin to sound muffled or sound like everyone is mumbling.
- Loss of hearing high-pitched sounds and frequencies. It may be more difficult to hear a doorbell ring or a bird chirping.
- Inability to hear when there is background noise. For instance, being unable to hear in a crowded restaurant or listen to a conversation when a radio is playing.
- Social isolation. If you have trouble hearing, you may distance yourself from people because it is hard to understand or follow the conversation. You may notice you have lost interest in social gatherings or do not want to participate in activities you once enjoyed.
- Tinnitus is a ringing or buzzing sound in the ears that may be constant or come and go. It is common for a person with hearing loss to experience these sounds or disturbances when they are in a quiet room or lying down to sleep.
You may have other symptoms, depending on your degree of hearing loss. Some adults report feeling fullness in their ears or feeling like something is blocking the ears.
Six Treatment Options for Presbycusis
If you are experiencing age-related hearing loss, talk to your healthcare provider about your treatment options.
Hearing loss can significantly impact your quality of life, and numerous treatment options are available to help you hear better.
First, you’ll need to see an audiologist for a hearing test.
You will likely get an audiogram, a test to determine which parts of your hearing you have lost. You will respond to sounds in one or both of your ears during the test.
Once your level of hearing loss has been determined, your doctor can help you with treatment options.
1. Prevention
Older adults that suffer from presbycusis can still protect the hearing they have left. Prevention is important to prevent severe hearing loss.
Prevention includes avoiding excessive noise exposure when you can, using hearing protection like earplugs in a noisy environment, and making sure you are using your hearing devices properly.
2. Hearing Aids
Unlike the type of hearing aid you probably remember older adults wearing in the late 80s and 90s, today’s hearing aids are extremely streamlined and virtually impossible to detect in a person’s ear.
Hearing aids collect sound waves in a microphone that changes them into electrical signals. The signals go to an amplifier in the hearing aid, which sends them directly into the ear with a speaker.
3. Cochlear Implants
Usually reserved for people with extreme hearing loss, cochlear implants create a bypass of the outer and middle ear and stimulate the auditory nerve directly.
By collecting sound and transmitting the information directly to the auditory nerve, the nerve can send the information to the brain as sound.
These devices rest on the outside of the skull and must be surgically implanted.
These implants can help individuals hear who were once deaf, dramatically changing their quality of life.
4. Speech Reading
Learning to interpret what someone is saying by reading their lips is an easy, non-invasive way of coping with age-related hearing loss.
This tool can help someone become more aware of conversation cues and aids in helping them determine what people say.
5. Assistive Listening Devices (ALDs)
Devices that can amplify sound or change voice to readable text are often given to people with age-related hearing loss.
Special electronic devices that convert voice to text or amplify sound on a telephone may be given to a person with age-related hearing loss to help improve their quality of life and make it easier for them to hear.
6. Proper Ear Care
The buildup of earwax can cause you to lose some of your hearing. If you already suffer from hearing loss, it can be even more difficult to hear spoken words. Your doctor can help you determine if an excess amount of earwax is one of your causes of hearing loss.
Preventing Age-Related Hearing Loss
Age-related hearing loss is a non-reversible condition. The structures in the cochlea (the special hair cells) can’t regenerate.
Although some age-related hearing loss is normal and non-avoidable, you can be proactive in protecting your ears to preserve normal hearing as long as you can.
Prevention methods include avoiding loud sounds (like fireworks, gunshots, or power tools).
When you know you’ll experience these types of sounds, wear proper hearing protection to ensure the structures in your ear are not at risk of hearing damage.
For more information and tips on how to keep healthy as you age, check out the USA Rx blog.
References, Studies and Sources:
How Do We Hear? | National Institute on Deafness and Other Communication Disorders NIDCD
Age-Related Hearing Loss (Presbycusis) | Cedars-Sinai