Patients affected by age-related hearing loss (presbycusis) are usually over 50 years old or older and have reduced hearing in the higher frequency ranges. In most cases, affected patients have particularly poor hearing in situations with strong background noise. The best treatment option for this condition is a hearing aid individually fitted to the patient, which can compensate for presbycusis.
What is presbycusis?
A hearing test or audiometry is used to diagnose diseases of the hearing organs. Typical fields of application are an incipient hearing loss or age-related hearing loss (presbycusis). Age-related hearing loss, also known as presbycusis, primarily affects people who are over 50 years old or older. In most cases, presbycusis affects both ears equally and relates to the higher frequency ranges of hearing. Affected patients usually have difficulty following conversations in which there are strong noises in the background. As the disease progresses, the hearing ability of affected patients continues to decline. Presbycusis is an inner ear hearing loss that affects the organ of Corti. To date, there are no cures for presbycusis.
Causes
The main causes of presbycusis are aging processes of the human ear, which negatively affect the hearing ability of the affected patient. There are also numerous factors that can have a favorable effect on the development of presbycusis. These can lie within the human body or outside it. These factors include diseases such as diabetes mellitus, high blood pressure or circulatory disorders. In addition, affected patients often have a genetic predisposition to age-related hearing loss. Other causes for the development of presbycusis are seen by physicians in the diet of the affected patient, in stimulants such as nicotine, in heavy exposure to noise or in the use of medications. These influencing factors can have a negative effect on the organ of Corti in the human inner ear, resulting in presbycusis.
Symptoms, complaints and signs
In most cases, age-related hearing loss can be prevented and occurs in almost all people at an older age. Age-related hearing loss is usually associated with distinct symptoms that negatively affect the hearing ability of the individual. Patients with this disease suffer from hearing loss and are thus no longer able to actively participate in conversations. Even ordinary listening to the radio or television is no longer possible. In severe cases, this can also lead to complete deafness. Word comprehension also decreases significantly due to age-related hearing loss. Often, this hearing loss is also associated with ringing in the ears, so that patients suffer from tinnitus. These noises in the ears have a very negative effect on the patient’s quality of life and can also lead to depression or irritability. However, age-related hearing loss can often be alleviated by the use of hearing aids. The symptoms usually intensify over time, so that the patient’s hearing ability continues to decline. Especially without the use of hearing aids, the ears continue to be damaged by loud noises. Further, however, this condition does not negatively affect the patient’s overall health.
Diagnosis and progression
In order to diagnose senile hearing loss, the affected patient should consult an ear, nose and throat specialist if he or she has the corresponding symptoms. He or she will first thoroughly inquire about the situations in which the hearing loss occurs to verify that the patient’s symptoms fit presbycusis. One indication that it is indeed a case of presbycusis is, for example, reduced hearing in the higher frequency ranges or in the presence of strong background noise. The ENT physician checks this with the help of a sound audiogram. Typically, both ears are equally affected by hearing loss in presbycusis. In addition, factors such as the patient’s age or existing diseases are known causes of presbycusis.In addition to age-related hearing loss, many patients complain of noises in their ears, which is also known as tinnitus. It can be assumed that the patient’s hearing ability continues to deteriorate with increasing age in the case of presbyacusis.
Complications
Senile hearing loss is a common symptom. It cannot be treated in most cases and occurs in older age in almost all people. Direct treatment of the eardrum is not possible. However, affected people can use a hearing aid to amplify certain sounds and hear better. Usually, no further complications or discomfort occur when wearing a hearing aid, so these hearing aids can be used without restriction. If the individual does not use a hearing aid, the age-related hearing loss will usually increase. This is because patients often keep increasing the volume of devices as they have poor hearing. However, this further damages the eardrum, increasing the age-related hearing loss. Often, ordinary daily life is no longer possible for the patients, so they are dependent on the help of strangers. As a result, the quality of life decreases significantly. To avoid old-age hearing loss, people should not expose their ears to loud noises unnecessarily in the long term. Also, music should only be listened to at an appropriately healthy level to avoid damaging the eardrum. It is advisable to use a hearing aid at a very early age so that age-related hearing loss does not continue to increase.
When should you go to the doctor?
Increasing age-related hearing loss is a natural problem that occurs gradually. However, no one has to accept the hearing loss that accompanies it as a matter of fate. Those affected should see a doctor as soon as their hearing loss begins to show. A specialist for ear, nose and throat diseases is the right contact person. The specialist for ENT diseases can determine the existing degree of hearing loss by means of various tests. It is also important to know all the present concomitant diseases of the age in order to estimate the progression of hearing loss. The increasing progression of hearing loss carries the risk of social isolation if left untreated. This makes early visits to the doctor all the more important. If possible, those affected should be able to continue to participate actively in life. For this purpose, the fitting of a hearing aid is usually essential. Alternatively, hearing training can first be initiated by the ENT physician. Presbycusis can be largely reversed by the fitting and use of a modern hearing aid, at least in the initial period. However, the hearing experience changes as a result of the hearing aids. The ear and the brain have to get used to the new soundscape at first. In the case of age-related hearing loss, the hearing care professional will fit the patient with hearing aids based on the doctor’s prescription. He or she can later adapt the devices to changed conditions. In the case of presbycusis, however, it is also important that any existing internal diseases are also treated. Some diseases can aggravate age-related hearing loss.
Treatment and therapy
Depending on how much age-related hearing loss affects the affected patient, most physicians recommend an individually fitted hearing aid. Especially for older people who already have severely impaired hearing, the prescription of a hearing aid often shows good results and helps to improve the quality of life. The hearing aid should be fitted by an experienced hearing care professional in order to achieve an effective improvement in hearing. Of course, the further course of presbycusis is regularly monitored by the treating ear, nose and throat specialist. So far, there is no scientifically proven way to treat presbycusis with medication. However, there are various medicinal methods available to the treating physician that can slow down the progression of the disease. Since presbycusis often occurs in combination with ringing in the ears (tinnitus), it may make sense to treat it with the help of a tinnitus noiser, for example. In this way, a significant improvement in the quality of life and hearing ability can be achieved with presbycusis.
Outlook and prognosis
Age-related hearing loss represents a dangerous symptom and usually occurs in most people at an older age.Unfortunately, it is not possible to treat sensorineural hearing loss causally, so that in some cases the symptoms can be alleviated and limited with the help of hearing aids or other hearing aids. In the worst case, sensorineural hearing loss can also develop into complete deafness, so that the affected person is significantly restricted in his or her everyday life. In some cases, the onset of age-related hearing loss or deafness can lead to psychological complaints or even depression. Patients are often dependent on the help of other people in their daily lives in order to be able to continue to cope. The patient’s quality of life decreases significantly as a result of this disease, although life expectancy itself is not affected. Age-related hearing loss can only be treated to a limited extent. In some cases, it progresses without much strain on the ears and cannot be stopped. However, with the help of hearing aids, the daily life of the affected person can be made easier. Likewise, learning sign language can also be useful for some patients.
Prevention
Some favoring factors are known for the development of age-related hearing loss, which should be avoided for prevention. It is therefore advisable not to expose oneself permanently or constantly to large amounts of noise or, if necessary, to wear earplugs if, for example, noise cannot be avoided at work. A healthy diet and avoidance of stimulants such as nicotine also help to prevent presbycusis.
Aftercare
Presbycusis is not curable. Therefore, follow-up care cannot aim to prevent the recurrence of the disease. Rather, the goal is to maintain quality of life and rule out complications. The right specialist for a necessary aftercare is the ear, nose and throat doctor. Often, after receiving a hearing aid, follow-up care takes place. This is because the disease progresses, so adjustments become necessary. The doctor primarily uses an audiogram for this purpose. Sounds and conversations are played to a patient through headphones at different volumes. Only in rare cases do sufferers continue to expose themselves to strong and harmful background noise. In follow-up care, physicians discuss these causes and, if necessary, point out how they can be remedied. If hearing deteriorates progressively, psychosocial problems can also occur. Establishing contact with other people becomes more difficult. Older people in particular then need help to escape isolation. Psychotherapy can then be useful. The purpose of follow-up care for senile hearing loss is to prevent hearing from deteriorating. Since hearing loss progresses in many sufferers, follow-up care is useful. The treating ear, nose and throat doctor decides on the rhythm.
What you can do yourself
Coping with everyday life and self-help play an important role in age-related hearing loss because the decline in hearing is largely due to central hearing loss, i.e., reductions in signal processing by the auditory centers in the brain. Just as targeted training can be used to maintain and improve cognitive abilities in old age, specialized hearing training as a self-help measure is also an important measure for those affected to improve their central hearing ability again. This includes, for example, the conscious inclusion of visual impressions such as lip movements and body language of the conversation partner. Hearing training can also be carried out in conjunction with getting used to a modern hearing aid, which uses computer technology to filter and process incoming sounds so actively that further processing in the brain is made a little easier. Above all, speech content can be better understood again, because sounds foreign to speech are muffled as far as possible and it is made easier for the brain to practice recognizing speech content again. Other important self-help measures consist of a healthy, balanced diet that contains natural components rich in vitamins and enzymes and with antioxidant effects as far as possible, in order to ensure optimal care of the brain. People in the closest social environment should discuss the problems of hearing loss with the affected person and determine behavioral patterns that will help the hearing impaired person to continue to be a full member of the social community.
