Ageing affects all parts of the body as well as the mind. Among those parts where the effects are often the most obvious are the ears, nose and throat. The reasons for this, besides normal ageing, are many other which include loud noises, infections, overuse of the voice and the consumption of tobacco, alcohol and drugs and other such substances. Some elderly people are affected more than others. However, about 33% of adults between 60 to 70 years of age are affected by hearing loss. Above 85 years, the percentage of those affected rises to 80. Generally, men suffer more from hearing loss than women and the onset is at a younger age. The most common type of hearing loss is that which is age-related. There are a number of conditions that could exacerbate the problem causing it to be more severe or advancing the onset. Regular screening for hearing loss is recommended for those above the age of 50.
Age Related Hearing Loss
This condition, the medical term for which is presbycusis, is a gradual, natural age-related occurrence. There are a number of causes for this, the most common of conditions and the most often seen are changes in the inner and/or middle ear, or changes in the nerves connecting the ear to the brain. Long-term exposure to excessively loud or continuous sounds can damage the ability to hear. Other medical conditions such a high blood pressure and diabetes and consuming medications, even if prescribed by a doctor for another health issue, may cause or contribute to hearing loss.
The common symptoms of hearing loss include:
Listening to the TV or radio at volumes so high that others are uncomfortable
Difficult in hearing over the telephone
Difficulty on following conversation between two or more persons
Thinking that others are speaking in very low volumes
Constantly being forced to ask people to repeat what they are saying
Inability to distinguish background and foreground sounds such as voices
Reluctance to meet people due to fear of not hearing what they are saying
The Types of Hearing Loss
Hearing loss can be divided into two categories:
Conductive hearing loss is the condition when sound waves are blocked from traveling to the inner ear due to deposits of wax, the presence or foreign bodies, fungal infections, bony growths and other obstructions. Other reason for the sound waves not being carried include impairment or perforation of the eardrum, infections, growths and tumours.
Sensory-Neural hearing loss occurs when there is damage to the auditory nerve or the structure of the inner ear. This condition is generally permanent and not reversible. The causes are similar to conductive hearing loss and also include autoimmune diseases and infections such as meningitis etc.
Treatments for hearing loss must be specific to the cause and nature of the problem. While there is no cure for age-related hearing loss, the identification and management of the problem, monitoring of any changes in the condition and staying abreast of new development in the treatment of the condition are all part of the long term care that both patients, family members and doctors needs to be aware of.
Vertigo and/or Balance Problems
Vertigo (dizziness) and difficulty in maintaining balance are among the most common ear related conditions faced by the elderly. The most common cause for balance issues is disturbances in the inner ear and the result is an increased likelihood of falling and getting injured. Balance disorders are often symptoms of another health problem, such as an ear infection, multiple sclerosis, strokes, high blood pressure, low sodium or high potassium levels etc. Reducing salt intake and remaining hydrated may reduce the severity of the condition.
In the case of vertigo, the patient feels that objects are spinning around him or her and this is often accompanied by nausea and vomiting. Other signs of vertigo include fainting, being lightheaded, blurred vision and disorientation.
Ringing In the Ears
A ringing sound in the ears, also known as tinnitus, is a common problem of the elderly. While ringing is the most common sound, it can also be heard are buzzing, clicking, hissing or roaring and it could be at a high or low volume. Tinnitus is often the first sign of age-related hearing loss. It may also be a sign of other health issues such as allergies, high blood pressure, the effects of medications taken for other health problems, etc. An ENT specialist may be able to prescribe treatments to manage the condition.
As already stated, hearing loss is a common problem in old age and the effect it can have on a person’s work and social life, emotional health, and the quality of life overall can be devastating. While age-related hearing loss is common, that is no reason not to seek medical advice on the matter. Neither is embarrassment at the condition. Early examination and diagnosis by and ENT specialist can help to manage hearing loss and the associated problems of vertigo, loss of balance, tinnitus and others.
There are a number of actions that can help to reduce the risk of age-related hearing loss. These include:
Avoiding exposure to loud sounds
Wearing ear protection in places where the sounds or sound levels cause hearing distress
Eating nutritious foods along with vitamin supplements, if required
Controlling other medical conditions like diabetes
There area range of medical measures and devices that can reduce the impact of hearing loss and help to improve a person’s feeling of wellbeing. The key to prevention, and control if the condition has already set in, is to have hearing tested regularly. If any problem is found, the earlier an ENT specialist is consulted, the better the chances are of managing the condition effectively and protecting the quality of life to the maximum extent.
Dr. Sundhari Veluchamy
Consultant ENT Head and Neck Surgeon