Age-Related Hearing Loss

Age-related hearing loss, also known as presbycusis, is one of the most common causes of hearing loss in older people. This form of hearing loss develops gradually and primarily affects the ability to hear high-pitched sounds, whilst lower frequencies are often preserved. This is caused by the natural ageing of the inner ear and the auditory nerve. As we age, the hair cells in the inner ear, which are responsible for detecting sound, become less effective. This leads to a gradual decline in hearing ability. It is estimated that around one 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 deteriorate?

Hearing loss in old age has various causes, which can be exacerbated by the natural ageing process and by external factors. One key factor is the deterioration of the hair cells in the inner ear, which, as we age, lose their ability to convert sound waves into electrical impulses that are transmitted to the brain via the auditory nerve. The auditory nerve itself can also become damaged over the years, which likewise leads to impaired hearing. This functional impairment occurs particularly in the ear, the point of direct 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 workplace can damage the inner ear and accelerate the ageing process of hearing. Medications, such as certain antibiotics or painkillers, can also lead to premature hearing damage. Conditions such as high blood pressure, diabetes and circulatory disorders also affect 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 age-related hearing loss develop gradually, which is why many people only notice the changes in their hearing at a late stage. Typical signs include difficulty understanding speech, particularly in noisy environments. It becomes difficult to make out voices, particularly those of women and children, as high frequencies become increasingly hard to perceive. It is also common to turn up the volume on the television or radio to compensate for the hearing loss. If you find yourself having to ask people to repeat themselves more often because you can no longer follow conversations properly, this is a clear sign of hearing loss. It becomes increasingly difficult to follow conversations, particularly in social gatherings or at public events. If such symptoms occur, you should not hesitate to consult an ENT specialist to determine the cause of the hearing loss and begin treatment at an early stage

How is hearing loss in older people diagnosed?

Hearing loss in older people is usually diagnosed using audiometry, in which the patient is asked to listen to various sounds at different frequencies. This determines whether hearing is within the normal range or whether there is hearing loss. Another test, tympanometry, measures the pressure in the middle ear and can provide indications of a problem with the eardrum or the middle ear. An important part of the diagnosis is the medical history, during which the doctor asks about the patient’s medical history to identify 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 older people:

• 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 inner ear’s response to determine whether the hair cells are still functioning correctly.
• These tests help to assess hearing loss and determine the appropriate treatment

Solutions for hearing loss in older people: hearing aids and cochlear implants

In most cases, hearing loss in older people is treated using hearing aids. These small devices amplify sounds and speech so that they can once again be heard clearly and understood. Modern hearing aids offer a wide range of features, such as connectivity with smartphones or televisions, to improve hearing and make everyday life easier. Another aid is cochlear implants, which are an effective solution particularly for severe hearing loss. These implants are inserted directly into the inner ear and stimulate the auditory nerve, allowing sounds to be perceived 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 for improving hearing perception:

Hearing aids not only allow for volume adjustment but also offer the ability to optimise sound quality depending on the environment. For example, the wearer can switch between different programmes to hear better in a quiet environment or to understand speech more clearly in a noisy room. Cochlear implants offer a significant improvement in hearing ability as they stimulate the auditory nerve directly and no longer require hair cells.

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 minimise the progression of hearing loss. The most important measures include:

Noise protection and hearing protection

Protection against 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 involving noise exposure. Long-term exposure to noise can cause significant damage to hearing and accelerate the ageing process of the brain. Loud music and machine noise, in particular, pose a risk to the hair cells in the inner ear. Protecting yourself from these noises helps to delay hearing loss.

Regular hearing tests

A regular hearing test with 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 assistive devices can be taken. During a hearing test, various frequencies are checked to determine whether hearing is impaired across all ranges or only at specific frequencies. Through regular tests, the doctor can monitor the condition of your hearing and adjust treatments accordingly.

Healthy lifestyle

A balanced diet, regular exercise and a healthy lifestyle play a key role in maintaining hearing. Blood flow to the inner ear and the auditory nerve is crucial for hearing function. A healthy diet rich in vitamins, minerals and omega-3 fatty acids supports this blood flow. Similarly, smoking and excessive alcohol consumption should be avoided, as these can raise blood pressure and impair blood flow to the inner ear, which accelerates hearing loss. Those who take care of their lifestyle are not only doing their general health a favour, but also their hearing.

Social impacts of hearing loss in old age

Hearing loss in old age has not only physical but also emotional and social consequences. Social isolation is particularly common due to difficulties in understanding conversations. People suffering from hearing loss in old age often participate less in social activities as they find it difficult to follow conversations. Furthermore, there is evidence that hearing loss can increase the risk of dementia, as the constant effort required to understand conversations places a strain on the brain. Cognitive impairments and memory problems can be exacerbated by impaired hearing.