Hey, did you hear about the guy who…
What?
I said, DID YOU HEAR… eh, never mind.
Losing the ability to hear clearly and well can have a profound, and usually negative, impact on life. Known as presbycusis (prez-be-KYOO-sis), age-related hearing loss often begins in our 30s and 40s, and the likelihood of hearing loss increases with age.
Presbycusis is extremely common, with 1 in 3 senior adults between the ages of 65 and 74 affected by it. But it happens so slowly and gradually that most of us don’t even realize our hearing is no longer what it used to be.
What causes hearing loss in elderly people, or senior adults
Generally, presbycusis or age-related hearing loss is caused by the usual wear and tear our bodies go through over time. Presbycusis happens gradually, often in both ears at the same time, at pretty much the same rate. Presbycusis also affects twice as many men as women.
There are quite a few forms of presbycusis, such as sensory, neural, cochlear, and strial. The most frequently occurring form of hearing loss in senior adults is sensory presbycusis.
Sensory presbycusis
Sensory presbycusis happens when cochlear hair cells no longer function properly.
The cochlea is a spiral-shaped organ, about the size of a pea, located inside the inner ear. Inside the cochlea are cochlear hair cells, so called because they are covered in microscopic tufts that resemble hair.
To explain a very complex process in basic terms, cochlear hair cells sway and bend to ‘catch’ sound waves. They then convert the vibration of these waves into electrical signals, which are transmitted to the brain.
Causes of sensory presbycusis, or hearing loss in older adults
There are several reasons why cochlear hair cells in older adults can become damaged, leading to sensory presbycusis.
- Age: The foremost reason for hearing loss is age. Unlike other cells that make up the human body, cochlear hair cells do not regenerate or reproduce in any way. This means that once lost or damaged, they’re gone forever. As a result, hearing loss brought on by damaged cochlear hair cells is permanent. This kind of hearing loss cannot be cured or reversed.
- Long-term exposure to loud noise: Cochlear hair cells are extremely sensitive to the movement of sound waves. Loud sounds are made by large sound waves; when these large sound waves move towards the cochlea, they force the microscopic tufts on cochlear hair cells to bend and sway more than they should.
Repeated or long-term exposure to loud sounds weakens cochlear hair cells, so that they can’t return to their original position properly and quickly. Because of this, they cannot effectively convert sound waves into electrical signals, and you experience a loss in hearing.
- Medications: ‘Oto’ is a prefix originating from the Greek word for ‘ear’. Ototoxicity is a side effect of certain medications used to treat heart disease and cancer. Ototoxicity is an especially frequent side effect of antibiotics whose names end in ‘mycin/micin’, such as streptomycin and neomycin.
Symptoms of ototoxicity include a ringing or buzzing sound in the ears (tinnitus), feeling unsteady on your feet or having trouble maintaining balance, having problems hearing clearly, and experiencing deafness, which can be either temporary or permanent.
- Genetics: Many people with sensory presbycusis have a family history of hearing loss.
- Chronic diseases: Sensory presbycusis can be brought on by health conditions such as chronic obstructive pulmonary disease (COPD), diabetes, heart disease, and high blood pressure.
- Stroke: An ischemic stroke happens when blockages in a blood vessel stop oxygen-rich blood from reaching vital organs. Deprived of oxygen, the organ’s cells begin to die. Research shows that cochlear hair cells start losing function after just one minute of oxygen deprivation, and die within one hour. Since cochlear hair cells do not regenerate, the loss of cells, and therefore loss of hearing, is permanent.
Signs you may have sensory presbycusis, or age-related hearing loss
Sensory presbycusis happens so slowly and gradually that it’s hard to pinpoint when hearing loss may have begun. To identify if you’ve developed sensory presbycusis, see if any of the following are true for you.
- You ask people to repeat themselves. One of the earliest giveaways of hearing loss is when you’re talking with someone and find yourself frequently asking, “What?”, “Sorry?” “Come again?” or similar questions.
- Talking to two or more people is a problem. A conversation that involves multiple people, especially if there is overlapping of speech, and frequent interjections and interruptions, leaves you struggling to separate voices and words. You feel confused and lost, and hesitate to participate in the conversation.
- You get told you’re too loud. People with reduced hearing may be unable to hear themselves when they speak. Consequently, they may assume others can’t hear them either, and so might unknowingly turn up the volume of their own speech.
- Your TV volume is too high. Has anyone in your family or home complained about how loud your television is? This might be doubly frustrating for you because even though the sound is loud, you still cannot make out what the people on TV are saying.
- You turn on subtitles or closed captions (CC). Do you instinctively turn on subtitles or closed captions when watching television or videos on your phone because it helps you follow the visuals better? This is an important indicator of hearing loss.
- You see the birds, but can’t hear them. When it comes to age-related hearing loss, higher pitched or sharp sounds are usually the first to go. If you’ve developed sensory presbycusis, you may not be able to hear birdsong, or may have trouble understanding the higher voices of children and women.
High-pitched sounds are light, sharp, and thin. Think of the sound of a flute or violin. A low-pitched sound is deep and full-bodied, like that produced by a tuba, bassoon, or bass guitar.
Hearing loss and its impact on quality of life
Health issues can bring a host of problems for senior adults, negatively affecting their quality of life, and hearing loss is no different.
Not being able to hear well or clearly may make you feel frustrated and embarrassed, especially if your conversation partner(s) display irritation at having to repeat themselves.
Sometimes, people talking to you may come across as angry or aggressive because of the effort they need to put into speaking louder. This can be frightening for older people.
These and other reasons may cause you to avoid meeting people, leading to isolation, loneliness, and depression.
Dangers of denial
Studies carried out on senior adults and hearing loss show that many people deny there’s anything wrong with their hearing.
Hearing loss can have dangerous consequences. It can stop you from understanding and absorbing important information about your health, finances, and any legal concerns. You may not be able to hear warning sounds, sirens, and alarms. Grandparents babysitting young grandchildren may not be able to hear if a child is in trouble.
Refusing to accept that your ability to hear well has been compromised may keep you from getting the help you need to slow down your hearing loss.
How do doctors diagnose age-related hearing loss
Your primary care physician will examine your ears using an otoscope. This is a handheld device with a light and magnifying glass that lets your doctor look inside the ear canal and check for damage, earwax buildup, infection, inflammation, or any foreign object that might be lodged inside.
Ear lavage
Your doctor may suggest deep cleaning your ear canals through a procedure called ear lavage, or ear irrigation. To do this, your care provider will use a bulb syringe to squirt warm water into your ear to flush out dirt, debris, and earwax buildup. While this will not restore hearing loss that has already occurred, it may help slow down the progression of hearing loss.
Hearing aids to manage hearing loss
Age-related hearing loss is permanent, irreversible, and incurable. Treatments and remedies therefore focus on slowing down progression and enhancing sounds. To treat sensory presbycusis, your doctor may recommend hearing aids.
Modern hearing aids have come a long way from the clunky, bulky contraptions of yesteryears. Small, discreet, sometimes barely noticeable, modern hearing aids amplify sound and may have additional features that reduce background noise and mask the ringing sound of tinnitus in the wearer’s ears.
Hearing care and hearing aids on Medicare
Medicare Original does not cover hearing aids or exams to fit hearing aids. However, many Medicare Advantage plans provide coverage for hearing care. Many chronic special needs plans for diabetes patients also provide coverage for hearing care.
A knowledgeable guide can help you find out if you qualify for such additional benefits. To learn more about benefits available to you, speak to a staff member at your nearest healthcare center, or call our Patient Relations Helpline at 800-941-1106.