Hearing loss in old age

Hearing loss in old age, also known as presbycusis, is one of the most common causes of hearing loss in old age. This form of hearing loss develops gradually and mainly affects the ability to hear high-pitched sounds, while lower frequencies are often retained. The reason for this lies in the natural ageing of the inner ear and the auditory nerve. With increasing age, the hair cells in the inner ear, which are responsible for perceiving sound, become less functional. This leads to a gradual deterioration in hearing. It is estimated that around a third of people over the age of 65 suffer from age-related hearing loss. The change therefore primarily affects the ear and its ability to process sound waves correctly.

Causes of hearing loss in old age: Why does hearing become weaker?

Hearing loss in old age has various causes, which can be exacerbated by the natural ageing process and external influences. One important factor is the wear and tear of the hair cells in the inner ear, which lose their ability to convert sound waves into electrical impulses that are transmitted from the auditory nerve to the brain with increasing age. The auditory nerve itself can also be damaged over the years, which also leads to impaired hearing. This functional impairment occurs particularly in the ear, the direct point of contact with sound waves. Another significant risk factor for hearing loss in old age is long-term exposure to noise, which often occurs over many years. Exposure to noise from loud music, machinery or environmental noise in the work environment can damage the inner ear and accelerate the ageing process of hearing. Medication, such as certain antibiotics or painkillers, can also lead to premature hearing damage. Diseases such as high blood pressure, diabetes and circulatory disorders also have an impact on hearing, as they impair the blood supply to the inner ear and reduce the functionality of the hair cells.

Symptoms of hearing loss in old age: when should you see a doctor?

The symptoms of hearing loss in old age occur gradually, which is why many sufferers only notice the changes in their hearing late. Typical signs include difficulty understanding conversations, especially in noisy environments. It is difficult to understand voices, especially those of women and children, as high frequencies become increasingly difficult to perceive. It is also common to turn up the volume on the TV or radio to compensate for hearing loss. If you notice that you have to ask questions more often because you can no longer understand conversations properly, this is a clear sign that you have hearing loss. Especially in social gatherings or at public events, it becomes increasingly difficult to follow the conversation. If such symptoms occur, you should not hesitate to consult an ENT specialist to clarify the cause of the hearing loss and start treatment at an early stage

How is hearing loss diagnosed in old age?

Hearing loss in old age is usually diagnosed by audiometry, in which the patient has to listen to different sounds at different frequencies. This determines whether the hearing ability is within a normal range or whether there is hearing loss. Another test, tympanometry, measures the pressure in the middle ear and can provide indications of a disorder of the eardrum or middle ear. An important part of the diagnosis is the medical history, in which the doctor asks about the patient's medical history in order to determine possible causes of the hearing loss. The ENT specialist will then decide whether treatment is necessary and what options are available

Most common tests for diagnosing hearing loss in the elderly:

• Audiometry: Checks hearing ability at different frequencies and volumes.
• Tympanometry: Measures the pressure in the middle ear and can reveal problems with the eardrum.
• Speech audiometry: Tests how well the patient can hear and understand speech at different volumes.
• Otoacoustic emissions: Tests the response of the inner ear to determine if the hair cells are still functioning properly.
• These tests help to assess the hearing loss and determine the appropriate treatment

Solutions for hearing loss in old age: hearing aids and cochlear implants

In most cases, hearing loss in old age is treated with the use of hearing aids. These small devices amplify sounds and conversations so that they can be heard clearly and intelligibly again. Modern hearing aids offer a variety of functions, such as connection to smartphones or televisions, to improve hearing and make everyday life easier. Another aid is cochlear implants, which are a particularly effective solution for severe hearing loss. These implants are inserted directly into the inner ear and stimulate the auditory nerve so that sounds can be heard again even in cases of severe hearing loss. However, cochlear implants are generally only suitable for people for whom hearing aids are no longer sufficient.

Solutions to improve hearing perception:

Hearing aids not only offer volume adjustment, but also the option to optimize the sound quality depending on the environment. For example, the wearer can switch between different programs to hear better in a quiet environment or to understand speech better in a noisy room. Cochlear implants offer a significant improvement in hearing, as they stimulate the auditory nerve directly and no hair cells are required.

Preventing further hearing loss in old age: what can be done?

Although hearing loss in old age cannot be completely prevented, preventive measures can slow down the process and minimize the progression of hearing loss. The most important measures include

Noise protection and hearing protection

Protection from noise is one of the most effective ways to prevent hearing loss. It is particularly important to wear earplugs or hearing protection in noisy environments, such as at work or during leisure activities that involve exposure to noise. Prolonged exposure to noise can significantly damage hearing and accelerate the ageing process of the brain. Loud music or machine noise in particular pose a risk to the hair cells in the inner ear. Protection against these noises helps to delay the loss of hearing.

Regular hearing tests

A regular hearing test by an ENT specialist helps to detect changes in hearing at an early stage. The earlier hearing loss is diagnosed, the sooner measures such as the use of hearing aids or other aids can be taken. During a hearing test, various frequencies are tested to determine whether hearing is impaired evenly in all ranges or only in certain frequencies. Regular tests allow the doctor to monitor the condition of the hearing and adapt appropriate therapies.

Healthy lifestyle

A balanced diet, regular exercise and a healthy lifestyle make a significant contribution to maintaining hearing. Blood flow to the inner ear and auditory nerve is crucial for the proper functioning of hearing. A healthy diet rich in vitamins, minerals and omega-3 fatty acids supports this blood circulation. Smoking and excessive alcohol consumption should also be avoided, as these can increase blood pressure and impair the blood supply to the inner ear, which accelerates hearing loss. Paying attention to your lifestyle is not only good for your general health, but also for your hearing.

Social impact of hearing loss in old age

Hearing loss in old age has not only physical, but also emotional and social effects. Social isolation is particularly common due to difficulties in understanding conversations. People who suffer from hearing loss in old age often participate less in social activities as they find it difficult to follow conversations. There is also evidence that hearing loss can increase the risk of dementia, as the constant effort to understand conversations puts a strain on the brain. Cognitive impairment and memory problems can be exacerbated by the lack of hearing perception.