Hearing loss is one of the most common conditions affecting older adults. Approximately 17 certain percent, or 36 million, of American adults say that they have some degree of hearing loss. Roughly one-third of Americans 65 to 74 years of age and 47 percent of those 75 and older have hearing loss. Men are more likely to experience hearing loss than women.

Hearing loss exists when there is diminished sensitivity to the sounds normally heard. The term hearing impairment is usually reserved for people who have relative insensitivity to sound in the speech frequencies. The severity of a hearing loss is categorized according to the increase in volume above the usual level necessary before the listener can detect it.

Hearing loss comes in many forms. It can range from a mild loss in which a person misses high-pitched sounds, such as the voices of women and children, to a total loss of hearing. It can be hereditary or it can result from disease, trauma, certain medications, or long-term exposure to loud noises.

There are several types of hearing loss – presbycusis, tinnitus, sensorineural and conductive hearing.

• Presbycusis is a loss of hearing that gradually occurs in most individuals as they grow older.
• Tinnitus, also common in older people, is the ringing, hissing, or roaring sound in the ears frequently caused by exposure to loud noise or certain medicines. This is not a disease but more of a symptom which may accompany other hearing problems.
• Sensorineural hearing loss occurs when there is damage to the inner ear or the auditory nerve. This type of hearing loss is permanent.
• Conductive hearing loss occurs when sound waves cannot reach the inner ear. The cause may be earwax build-up, fluid, or a punctured eardrum. Medical or surgical treatment can usually restore conductive hearing loss.

Hearing loss may affect the hearing threshold, the volume at which a patient can hear sound, expressed in decibels (dB), discrimination (the ability to differentiate among various speech sounds), or both. The high frequencies of sound, expressed in hertz (Hz) may be affected first.

The loss of hearing affect both ears symmetrically occurs slowly over time. It is most difficult to hear high-frequency sounds, like someone talking. As hearing gets worse, it may become difficult to hear sounds at lower pitches.

Symptoms include:

• Difficulty hearing in noisy areas (also called the “cocktail party syndrome”).
• High-pitched sounds such as “s” or “th” are hard to distinguish from one another.
• Men’s voices are easier to hear than women’s.
• Other people’s voices sound mumbled or slurred.
• Family members may complain that the television is turned on too loud.
• Often asks for words to be repeated.
• The person avoids social situations, religious services, and movie theaters.
• Music lovers may complain that music does not sound as bright.
• Certain sounds seem overly loud.
• Ringing in the ears.

A complete physical exam is performed to rule out medical conditions that can cause hearing loss. The patient may be sent to an ear, nose, and throat doctor and a hearing specialist (audiologist). Hearing tests (audiometry, tuning forks test and speech audiometry), can help determine the extent of hearing loss. The typical audiometric test result is a bilateral mild-to-moderate hearing loss. Hearing is usually best in low frequencies and poorest in high.

Patients with central or auditory processing problems, may have a low word recognition score, because their nerve system does not faithfully reproduce the clarity of speech, regardless of loudness. These patients will have difficulty understanding conversational speech without visual cues, despite being able to hear sound with a hearing aid.

There is no known cure for age-related hearing loss. Treatment is focused on improving everyday function. The following may be helpful:

Hearing aids. The types available are body-worn/pocket, behind the ear (BTE), in the ear (ITE), or, in the canal (ITC) types, depending on severity of the hearing loss.

Telephone amplifiers and other assistive devices. Hearing aids with a telecoil can be set on “T” to receive (through magnetic induction) the signal from the magnetic coil inside the telephone. While the telecoil is activated, the microphone is usually inactivated; therefore, the background sounds from the room in which the person is speaking is not amplified.

Speech reading (such as lip reading and using visual cues to aid communication). Other people can help the person with presbycusis a lot by simply speaking clearly: the speaker should pronounce each syllable carefully and clearly but without undue exaggeration.