Aging and Hearing Loss

Aging and Hearing Loss

As we age there a lot of changes in both the ear and in the brain that can impact the way we hear.  The auditory system is made up of the outer ear, the middle ear, the inner ear and the brain.  Age-related changes can occur in each but most of the changes take place in the inner ear and brain.  The inner ear contains “hair cells” that are susceptible to damage as we age, particularly affecting how we hear high-pitched sounds.  In the brain, neural slowing occurs that can be attributed to cellular changes in neurons, which transmit and process information.  A combination of changes in the inner ear and brain cause age-related hearing loss.  There are many other factors apart from age that can contribute to hearing loss as we age. These include noise exposure, trauma, diabetes, cardiovascular disease, infections, and genetics.

The normal aging process also affects such skills as selective attention, short-term memory, processing speed, reaction time and sensitivity to soft sounds.  Many of these help us to carry on conversations, to localize sound and aid in the ability to hear in noisy settings.  The brain processes sound and with age seniors are not able to use the brain as efficiently as younger adults.  As a result, there is more difficulty organizing sound into meaningful stimuli.

Age-related changes in the auditory system reflect the importance of regular hearing tests for seniors.  Hearing loss left untreated can cause depression, anxiety, insecurity and decreased social activity.  Hearing aids can relieve many of these negative symptoms and have been known to improve communication and emotional well-being.  Unrecognized hearing loss can be mistaken for cognitive decline.  Many screening and diagnostic tests for dementia require the patient to listen to a set of instructions thus cognitive decline can be overestimated with hearing loss.

Hearing loss and dementia often coexist in seniors but individuals with dementia are not always treated for hearing loss.  With the assistance of a spouse, family member or care worker hearing aid fittings can be successful.  Individuals with dementia wearing hearing aids are more alert, easier to communicate with and more aware of their environments.

For seniors with diagnosed hearing loss there are some effective strategies that can help improve communication:

  1. When hearing aids are recommended it is important for seniors to get digital automatic hearing aids. This will enable them to put their aids in the morning and remove them at night without having to worry about program buttons or remote controls.
  2. Managing expectations is important when accepting hearing loss.  It is important to have a realistic idea of which situations will be a struggle.  Especially with hearing aid fittings it is important to discuss expectations with your audiologist or hearing instrument specialist.  With the aging brain, seniors may still have trouble in challenging environments such as noise even with an aid.
  3. Whenever possible decrease all sources of background noise.  This will make it easier to hear the target signal.  For example, when watching TV use mute during the commercials and this will make conversations flow better.
  4. It is important that communication partners understand the importance of pacing.  Clear speech is produced when the speaker talks slightly louder and slower, uses frequent pauses after phrases and makes sure to enunciate all sounds.  The speaker does not exaggerate speech and retains a lively voice.  Clear speech can eliminate the need for repetition and decreases misunderstandings and frustrations.
  5. Follow-up programs are important for seniors.  This may include either group sessions or follow up appointments with a hearing health care worker.  In follow-up appointments is often a good idea to involve either a spouse or close family member.  This can help with everything from understanding and accepting hearing loss to hearing aid fittings and communication strategies.

It is important for all seniors to have a full audiological evaluation regardless of whether or not they are having difficulty.  Please contact our office if you or a loved one could benefit from a hearing assessment!

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