Oscar Wilde famously wrote and I quote, “the tragedy of old age is not that one is old, but that one is young”. As we delve into it further and look around us, one of the most common sights is the elderly struggling with their not so perfect ears. After a certain age our ears do not function as was the case before. Age-related hearing loss, or as we doctors call it, presbycusis, is the deterioration of hearing that occurs as one grows old. It is a progressive condition and occurs in both ears almost equally. The higher frequencies of hearing tend to get affected first.
A study found that among all the participants aged between 40 and 86, 36.1% suffered from age-related hearing loss. The prevalence rate increases with age. Another study of participants aged between 70 and 80 found that 80% of them suffered from presbycusis of various levels.
The problems associated with decreased hearing are multi-fold. The sufferers, in addition to not hearing properly, frequently complain of ringing noise inside their head, loneliness, depression, irritability and giddiness. A few point towards a very discomforting problem and that is they hear extra loud when someone raises their voice. Look at that, when we speak louder so that our grand-pa hears better, he is actually hearing it louder than what we intend. Others complain about inability to understand speech though they hear it.
Science behind hearing loss
When we go to the science of it, the hearing loss in old age occurs due to damage in the nerve related to hearing and the inner ear. Sound is transmitted to the inner ear where it gets converted to electrical signal and goes via the auditory nerve to the brain. With age the neural pathways and sound conversion become rusty. There occurs imbalance of various neurotransmitters which result in faulty transmission. Since the inner ear also houses the organs for balance, these patients often complain of spinning sensation and imbalance. It affects the higher frequencies first. It affects speech discrimination with time. A few suffer from a rather bizarre problem and that is abnormal growth of loudness. There is exaggerated perception of sound, called recruitment.
Some of the risk factors implicated in early development of presbycusis are
- Diabetes mellitus
- Male gender !!
The one thing that you can do to prevent early hearing loss is to avoid loud sounds. Wear ear muffs when you know some loud sounds are going to occur.
Treatment for Age-related Hearing Loss
We encounter a lot of patients with hearing loss. Get an online consultation with us if you have a loved one who is suffering. Such a loss in the elderly, which is permanent, has some treatment options.
- Hearing Aids – these devices, digital these days, amplify the sound. They come in a variety of sizes, shapes and costs. We have devices which are barely visible outside the ear canal
- Assistive Devices – they may be fitted to telephone to amplify the sound. There are devices which convert speech to text which can be read. Headphones and earphones block out the background noise, helping to hear better.
- Speech Reading – in those where the hearing has completely deteriorated, one can provide training to read speech or lip reading.
- Cochlear Implants – these convert the sound into electrical code and directly stimulate the nerve. It’s a surgical procedure and costly as well.
In my practice, the most common issue with those who use hearing aids is non-compliance. The reasons given are poor benefit, background noise, discomfort, poor sound quality, battery problems and so on. Although the aids are like any other gadgets, you need to understand that they need regular tuning as per your hearing. It so happens that with time the hearing in each frequency changes slightly. Therefore one needs to take the aid back to the audiologist who can tune it for you. I always encourage my patients to think of the hearing aid like a pair of glasses. This motivates them to get used to the feeling of something inside the ear.
Dealing with a loved one who suffers from hearing loss can be difficult. They tend to be lonely and irritable. We ourselves get tired of making them understand. While it is important to get them to use their hearing aid, equally important is to change our attitude towards them. Let us treat them the way they treated us when we were young. For we cannot let them feel that growing old is a tragedy but only a natural way of feeling love from family and friends.