Articles

Variation of Hearing Loss in a Life Cycle

By Ms. Lakshmi R Menon : Speech language pathologist

The hearing loss that people incur with advancing age is called presbycusis. It is the most common kind of hearing loss affecting the auditory nerve. The incidence of presbycusis seems to be increasing; understandably when one considers that people live much longer than they used to and that we now have a substantial percentage of senior citizens in this country. The loss of hearing by presbycusis is rather slow, insidious process and probably starts early in life, although the symptoms of hearing loss are usually not manifested until the person is over sixty years of age. Men are more commonly affected than women. The higher frequency sounds are seldom heard, and as the disorder gradually progresses, the person has trouble in hearing low frequency sounds as well. Comprehension of speech may be affected to a much greater degree than would be expected from thresholds (the minimal intensity which is audible by the individual) on a pure tone audiogram (a graph of thresholds at various frequencies of tone). Even in the cases of mild hearing loss, the person may have extreme difficulty understanding speech. Consequently, and making matters even worse, when older persons have auditory difficulties, they may be regarded as somewhat "senile" because of inappropriate responses and confusions which can occur. Obviously the effects of presbycusis can be dramatic, disabling and complex. It is evident because of age related changes in the following locations: within the inner ear, the auditory nerve, the central pathways and in the cerebral cortex of the brain. It has also been stated that the hearing loss is due to the wear and tear of the ear from everyday living in our noisy society. The causes of presbycusis also include loss of hair cells, hereditary causes, ageing, side effects of some medications. Studies on primitive tribes do not reveal merely the amount of loss with age that is seen in industrialized societies. It is likely that several subtypes of presbycusis exist mechanical, sensory, neural, central and that individual cases can reflect more than just one cause. And of course some people will be relatively good hearing even into very old age.

The are the following common symptoms of Presbycusis,

However each individual may experience symptoms differently.
Symptoms include

• High pitch sounds, such as "s" or "th" are hard to distinguish
• Conversations are difficult to understand, particularly when there is background noise
• Men's voices are easier to hear than women's
• Some sounds seem overly loud and annoying.
• Tinnitus may occur in one or both ears.

Treatment options for Hyperacusis

• Avoiding loud noises and reducing noise exposure
• Wearing ear plugs or special fluid filled ear muffs
• Hearing aid
• Assistive devices such as telephone amplifiers
• Training in speech reading

Rehabilitation in this type of case should involve family counselling so that its members can do their share in improving communications. We often find improvement in communication by pointing out to the family that shouting at the hard of hearing persons do no good, and that instead they should talk more slowly and distinctly.

Detailed evaluation, hearing aid testing and prescription will be done by Audiologists. The hearing aid or assistive devices will be suggested based on the type and degree of hearing loss. Regular follow-up is advisable to monitor any deterioration or change in the level of hearing loss.