Age-related Hearing Loss: What is Presbycusis? - Attune
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Age-related Hearing Loss: What is Presbycusis?

age related hearing loss

Age-related hearing loss, or Presbycusis, is a reduction in hearing that occurs as a person gets older. Age-related hearing loss can begin in the thirties or forties and gets worse over time.  For most people, both ears are affected.

Age-related hearing loss usually begins in high frequencies. The first signs of hearing loss are often finding more and more difficulty in understanding what people are saying, especially in situations where there is background noise, such as restaurants. Often a person describes a lack of “clarity” rather than a lack of “volume”. 

As the hearing loss occurs quite gradually, the signs of hearing loss may be noticed by other people, not the person with the hearing loss. The person developing a hearing loss may start asking for repeats, turning up the television or raising their own voice without being aware of it.

Age-related hearing loss, if left untreated, can negatively impact a deaf or hard of hearing person’s quality of life:

  • Hearing loss tends to isolate people from others and may lead to feelings of loneliness and social isolation
  • There is also increasing evidence of a link between untreated hearing loss and dementia. 
  • Untreated age-related hearing loss can also cause safety issues. As people’s high-frequency hearing reduces, they can have increasing difficulty hearing sounds such as smoke alarms, doorbells and the telephone ringing.  
  • They may also struggle to tell the location of a sound.

Age-related hearing loss is a widespread health condition affecting people as they age. One in six Australians is affected by hearing loss. With an ageing population, the number is expected to increase to one in four by 2050.

Causes of Age-Related Hearing Loss

There is no single cause of age-related hearing loss. Age-related hearing loss is caused by a combination of genetic, environmental and lifestyle factors. Presbycusis occurs due to damage in the hearing cells (hair cells) in the inner ear (cochlear) and changes in the nerve between the ear and the hearing centres of the brain. These changes are what leads to the signs of hearing loss mentioned above. Generally, age-related hearing loss does not significantly affect the outer or middle ear structures.

Environmental factors can also play a part in age-related hearing loss. Factors include:

  • Exposure to loud sound (either through work or recreationally)
  • Exposure to certain medications, including some chemotherapy drugs and some antibiotics, exposure to certain thinners, solvents and heavy metals and smoking

All of these factors have the capacity to damage cells in the inner ear (cochlear) and can worsen age-related hearing loss. Other medical conditions that are commonly found in older adults, such as cardiovascular disease and diabetes, can also negatively impact age-related hearing loss if they are not kept under control.

identify age related hearing loss

How to Identify Age-Related Hearing Loss

If you feel you recognise signs of age-related hearing loss in yourself, it could be time to have a hearing test. See your Audiologist to have a full hearing assessment. It is the single best way to determine if you are developing age-related hearing loss or have another issue occurring with your ears. Once the type and severity of your loss have been determined, your Audiologist can help advise you on possible treatment options available to help improve your age-related hearing loss.

Can age-related hearing loss be reversed?

Age-related hearing loss cannot be reversed and is permanent. However, the signs of hearing loss can be treated. The most common treatment for age-related hearing loss is fitting hearing aids

Today’s hearing aids are small, discrete and easy to use. They can be rechargeable and automatic in the way they function, so the wearer only has to put them in, leave them alone, and the hearing aid adjusts itself to the various environments and sounds around the wearer. Some hearing aids can also connect via Bluetooth to devices like phones, iPads and televisions to further improve listening ability when using these devices. Should hearing aids not be appropriate, cochlear implants may also be an option.

It can also help to educate the people you communicate with, such as friends and family on ways they can help you hear better. For example, facing the person with a hearing loss when speaking, trying to minimise background noise when having a conversation, getting their attention before starting a conversation. These techniques can make it much easier for a person with age-related hearing loss to communicate successfully.

Age-related hearing loss is the most common sensory loss to occur with age. Most people are likely to feel its effects as they get older. By being aware of the signs of hearing loss, we know when to be tested and hopefully receive help to stay connected with the people who matter in our lives.

asked questions

Age-Related Hearing Loss: Frequently Asked Questions 

  • How common is hearing loss? 

According to the World Health Organization, hearing loss becomes considerably more common as we get older. It is estimated that one in three people over the age of 65 will have some degree of hearing loss, and that figure increases again to one in two when aged over 75.

  • What causes hearing loss?

Hearing loss can have a wide range of causes, including wax blockage, infections, damage to the middle ear and noise exposure, but the most common by far is Presbycusis or age-related hearing loss. Presbycusis is caused by general wear and tear to the cochlear hair cells in the inner ear. It is usually symmetrical, affecting both ears the same, and irreversible, and therefore cannot be fixed using medication or an operation. 

Exposure to loud noise over a prolonged period of time can also impact our hearing. This noise exposure can also cause damage to the stereocilia (or hair cells) inside the cochlea, which do not regenerate and cause permanent damage to hearing. 

  • Can hearing loss be avoided?

As a number of factors can influence hearing loss, it is almost impossible to prevent hearing loss, particularly Presbycusis. Wearing hearing protection during exposure to loud noise has been proven to reduce the impact of these sounds on the cochlear hair cells, but even the most diligent individuals can still wind up with a hearing loss caused by other factors. There is also genetics to consider: hearing loss is known to run in families, so you may be genetically predisposed to hearing loss, through no fault of your own!

  • What are the early signs of hearing loss?

Often, it will be others that notice your hearing problem before you do! Early signs of hearing loss include asking others to repeat themselves several times in conversation, difficulty hearing in noisy environments, difficulty hearing in group situations, and turning the TV to a louder volume. It can often take years before you realise this is a problem!

  • How do I get my hearing tested?

If you have concerns about your hearing, first visit your General Practitioner. They will be able to tell you if you have a wax blockage or an ear infection, which can then be treated appropriately. Your GP will then be able to refer you to an Audiologist, where a hearing assessment can be performed. The Audiologist will also check your ears again for wax or infection, perform a test of middle ear function, called a tympanogram, before testing your hearing. 

A hearing test is usually carried out in a soundproof room or booth, using headphones or earphones to present a series of sounds, where you will be asked to press a button every time you hear a sound. The idea is to find the quietest sound you can listen to, across a range of different frequencies (pitch of sound). The Audiologist will then be able to explain your results and make recommendations based on these. 

  • If I have a hearing loss, do I need to wear a hearing aid?

Should your hearing test indicate a hearing loss, you may benefit from wearing hearing aids. Suppose your hearing loss is asymmetrical or your Audiologist suspects an underlying medical condition. In that case, you may first be referred to an Ear, Nose & Throat (ENT) doctor to rule these out. If your hearing loss is symmetrical and appears to be an age-related impairment, hearing aids will likely be discussed. 

Modern hearing aids are all digital, meaning they are programmed to your individual hearing loss to improve sound quality and clarity. A wide range of hearing aids are available, which your Audiologist can take you through and help choose the right option for you. 

  • Do I need to wear two hearing aids or just one?

Generally speaking, it is far more beneficial for symmetrical hearing losses to wear a hearing aid in each ear than just one. There is a lot of research that shows the use of two hearing aids greatly improved hearing in noisy situations, and can also help to slow the rate of hearing deterioration. 

a cochlear implant

  • Would I be better off with a cochlear implant?

Cochlear implants are generally recommended to those with severe to profound hearing impairments, where they cannot receive adequate benefit from traditional hearing aids. It is not recommended for those with mild-moderate hearing losses, as hearing aids are less expensive and do not require invasive surgery. 

  • Will hearing aids help to get rid of the ringing sound in my head?

Tinnitus is commonly described as a ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It may be soft or loud, high pitched or low pitched. You might hear it in either one or both ears. Tinnitus often accompanies a hearing loss, and in most situations does not have an underlying medical cause that would require attention. 

Although there is no cure for tinnitus, hearing aids have been proven to be one of the few successful management strategies in reducing the volume of the ringing. The theory behind this is that by picking up environmental sound using the hearing aids, the hearing aid wearer’s focus is shifted away from the tinnitus, and the tinnitus becomes less noticeable as a result. 

  • I’m a pensioner. Will the government subsidise my hearing aids?

Suppose you are an aged pensioner, a disability pensioner or a veteran. In that case, you may be eligible to apply for a voucher from the office of hearing services, which allows subsidised hearing tests and hearing aids through the government. These can be fully subsidised, or if you desire smaller or more technologically advanced hearing aids, you may decide to ‘top-up’ and receive partially subsidised devices. Your Audiologist will help to point you in the right direction!

  • So how do I go about getting my hearing tested?

If you are on a pension, there is no need to visit your GP for a referral, call or visit your local Attune Hearing clinic. Our friendly customer care assistants will be able to check your eligibility and can apply for the hearing services program on your behalf. 

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