Presbycusis

Presbycusis is a progressive bilateral hearing loss associated with ageing. Presbycusis is caused by degenerative changes in the middle ear, inner ear or nerve pathways to the brain that occur with age.

Symptoms

Hearing loss, usually affects both ears equally. Typically high frequency sounds, including the consonants s, f, t, k and p are lost first. This can make some speech sound muffled. Female voices may be harder to hear than male voices due to the frequency difference. Conversation on a one to one basis in a quiet setting is usually fine but in a crowded room with lots of background noise, hearing may be noticeably worse. Ringing in the ears (tinnitus) may also be reported. Presbycusis may be first detected by family and friends because it is a gradual process that the person adjusts to over time. A GP may conduct a preliminary hearing test and examination of the ear before referring onto an audiologist for formal testing.

Statistics

Presbycusis is the most common type of hearing loss and very common in people over 55 years old. Around 60% of people over the age of 70 have a hearing loss of 25dB or greater. Hearing loss is the third most common medical condition (after hypertension and arthritis) in the elderly.

Diagnosis

Presbycusis is diagnosed using the usual hearing tests for sensorineural hearing loss employed by an audiologist.

Treatment

Presbycusis is a slowly progressive condition. Because it begins late in life, it is unlikely to cause complete hearing loss and can usually be managed well with hearing aids. Presbycusis is not a preventable condition. It may be compounded by other hearing problems including noise-induced hearing loss, hereditary factors, health and some medications. Maintaining good health, preventing noise exposure and reviewing medications with a practitioner may help to maintain hearing. Treatment for presbycusis depends on the severity of the problem and may include avoiding loud noises and protecting the ears from noise damage, and using hearing aids and other assisted listening devices. The Audiologist plays an important role in advising the most appropriate aid, fitting it correctly, and then instructing the hearing aid wearer on correct usage. Learning to lip-read and reducing background noise will aid conversation.