Presbycusis - Causes, Symptoms, Diagnosis, and Management

Introduction:

Hearing loss related to age or presbycusis can occur in one or both ears. Hearing loss occurs so slowly that it is difficult to realize that the efficiency of hearing is reduced. Hearing is an event that occurs when sound waves are converted into electrical signals, and these signals are transferred by the auditory nerve to the brain in various steps:

What Is the Prevalence of Age-Related Hearing Loss?

It mostly affects people in the age group of approximately 60 to 75 years of age with hearing loss and difficulty in hearing in the age group above 70 years.

What Are the Causes of Age-Related Hearing Loss?

• Abnormal changes in the:

  • Inner ear.

  • Middle ear.

  • Hearing pathway.

• Continuous exposure to loud noise.

• Genetics.

• Damage or loss of hair cells.

• With increasing age.

• Smoking.

• Excessive use of earphones or other ear devices.

• Medicinal side effects like cancer medications or drugs that are toxic to the ears.

• Systemic diseases like diabetes and heart diseases.

What Are the Causes of Presbycusis?

Presbycusis is a condition that is caused due to any alteration in the inner ear which occurs as a person ages. It usually affects both ears and occurs gradually. Many people get affected by age-related hearing loss and noise-induced hearing impairment. In the long run, loud noises tend to damage the sensory hair cells, which is the segment of the ear that allows hearing. Some common causes of age-related hearing loss are,

• Diabetes.

• Increased blood pressure.

• Family history of hearing impairment.

• Continuous exposure to high noise.

• Aging.

• Destruction of hair cells.

• Side effects of certain medications such as Aspirin.

This condition can also be caused due to alterations in certain regions such as

• Alteration in the inner ear.

• Changed within the inner ear.

• Alteration along the nerve path.

What Are the Signs and Symptoms of Presbycusis?

• Hearing slurred speech when other people talk.

• Ringing sound in the ears.

• Difficulty in listening to high-pitched sounds.

• Men's voices are much easy to understand.

How Can Age-Related Hearing Loss Be Diagnosed?

• Physical Examination: An otoscope (small instrument with light) is used by the doctor to check the outer ear canal, eardrum, ear canal blockage with ear wax or other external objects, and ear infections.

• An Audiogram: This is performed to check whether each sound can be heard or not to identify the severity of the hearing loss.

• Pure Tone Test: This test is done for patients who are in rehabilitation, including patients who are using a hearing aid.

• Hearing in Noise Test (HINT): This test is done to evaluate a person's ability to hear in both loud and quiet environments.

• Central Auditory Processing Disorder (CAPD): It is common in patients with presbycusis, where a person has normal hearing, but the sound is disturbed by background noise. In this test, the speech-hearing test is done in a noisy place where the results are compared to the pure-tone test.

How to Prevent Age-Related Hearing Loss?

It can be prevented by,

• Avoid using earphones or hearing aids for a longer duration.

• Fix the volume for earphones at a safety level.

• Avoid smoking.

• In case of any ear infections, get it checked by the doctor immediately.

• Keep the ears clean and dry.

• Avoid cleaning the ear with external objects to prevent trauma to the ears.

• Avoid places with loud noise as much as possible.

Age-related hearing loss is not a reversible condition, so prevention is very important.

What Are the Possible Treatments for Age-Related Hearing Loss?

• Hearing Aids: It is a small electronic instrument that is worn in or behind the ear to hear the sound loud and clear.

• Cochlear Implants: These are electronic devices that are implanted surgically into the inner ears of a person having severe hearing loss or who are almost deaf.

• Bone Anchored Hearing System: It is designed to transfer sound through bone conduction.

• Assistive Listening Devices (ALDS): Various types of assistive listening devices are available for hearing loss, like hearing loop systems, Infrared systems, and personal amplifiers. These devices help people to hear clear sounds even with a lot of background disturbance.

• Alerting Devices: Sound, light, or vibration devices are kept in the house to alert for any particular event occurring.

• Augmentative and Assistive Communication Devices (AACD): These devices help people with communication disorders by using simple picture boards or any computer program that can convert text to speech format.

How to Select the Most Suitable Hearing Aid?

• Visit an ENT (ear, nose and throat) specialist to make the correct diagnosis of the problem after a physical examination.

• The type and degree of hearing loss are identified by the specialist after performing a test.

• A test or trial is conducted to find an appropriate hearing aid by the specialist and then advised to the patient.

How to Communicate With a Person Who Has Age-Related Hearing Loss?

• Use shorter phrases to speak.

• Avoid any background noise during the conversation.

• Face the person having hearing loss while talking.

• Speak slowly and clearly.

• Speak louder than normal.

What Further Research Is Conducted for People With Age-Related Hearing Loss?

Much research is conducted on assisted technology for people with age-related hearing loss:

• Brain-Computer Interface Research: Research is making a prosthetic device that can convert a person's thoughts into speech and sentences. These devices will be small electrodes that will be implanted into the mortar cortex of the brain.

• Improved Devices for People With Hearing Loss: Ongoing research on forming new portable devices so that multiple users can message each other, and it is displayed in real-time.

• Improved Devices for People With Speaking Problems: Research is going on to form text-to-speech converting devices for persons who are at risk of losing their speaking ability.

What Are the Complications of Presbycusis?

• Difficulty in conversation with family and friends.

• A feeling of depression and loneliness.

• Difficult to understand important instructions also, like health, financial, and legal information.

• Loss of self-confidence to join a conversation.

Conclusion:

Age-related hearing loss is a very slow and progressive process affecting mainly people above 65 years of age. Hearing loss is a slow process, so realizing any change or loss of hearing abilities is even more difficult. As it is an irreversible condition, prevention is very important. Timely care of all health problems on a priority basis at older age helps to prevent age-related diseases such as presbycusis.