presbycusis

presbycusis
International Classification (ICD) H91.-

Basics

Regardless of whether you want to admit it or not, the senses simply diminish with age. This includes not only the increasing loss of visual acuity, but also the increasingly severe age-related hearing loss. And this often causes more trouble than one would have suspected in one's younger years.

The technical term for age-related hearing loss is presbycusis. It is also often referred to as age-related hearing loss. The big problem with the condition is that it cannot be cured. Instead, attempts must be made to make everyday life as unrestricted as possible with technical aids.

Prevalence of presbycusis

Presbycusis can occur from the age of 40, especially if there is a lack of protection against noise. In men, it is very widespread from the age of 65, while women usually develop the disease later.

Causes

Age-related hearing loss is a symptom of old age. Over time, the so-called organ of Corti, which is responsible for hearing, wears out. This leads to a noticeable hearing loss, especially in the frequency ranges where our hearing is most sensitive. And it is precisely in this range that large parts of our speech fall.

In the case of presbycusis, it is primarily the function of the inner ear with its sensory cells that is impaired. But also the transmission via the auditory nerve and the interpretation in the brain is increasingly impaired by the degradation processes.

Factors that damage the ear

Nevertheless, there are some factors that promote the wear and tear of the hearing organ. For example, constant noise can cause excessive damage to the ear, making presbycusis occur earlier or more severely.

In addition, genetic influences and the age-related reduction of brain mass also play a major role, of course, which should not be neglected. Even if the organ of Corti still functions perfectly, damage to the auditory nerve or the corresponding areas of the brain can lead to difficulties in understanding.

Symptoms

A slow increase in hearing loss is typical. While this is hardly noticeable at first, there is a progressive impairment, especially in speech comprehension. Some describe it as if they now hear everything through a helmet of cotton wool that becomes thicker and thicker.

From impaired speech comprehension to social withdrawal

In noisy surroundings, it becomes increasingly difficult to understand speech, especially sentence comprehension is severely impaired. In addition, the background noise is increasingly perceived as disturbing, as it lies in a frequency range that can still be heard well.

This is followed by social withdrawal in many sufferers. If communication is impaired and one has to ask several times to finally understand what the other person has said, then it is also very difficult to feel comfortable anywhere.

Tinnitus as an additional symptom

Even if it is not absolutely necessary, many people describe a tinnitus in addition to the age-related hearing loss. This can occur only now and then or always be there. Also the quality of the sound, i.e. whether it is a whistling, a hissing, a knocking or something else, and the volume can vary from person to person.

The extent to which the hearing is damaged and which speech frequencies are affected is very individual, which is why no information can be given on the course of the symptoms.

Diagnosis

Even if the diagnosis of age-related hearing loss seems very simple and trivial at first glance, it is essential to exclude all other causes.

Exclusion of diseases that reduce blood flow

Above all, diseases that negatively affect the flow properties of the blood and the structure of the vessels can also lead to a loss of hearing. These include not only diabetes mellitus and arteriosclerosis, but also hyperlipidemia of the blood. These should of course be ruled out as causes and treated intensively if they can be diagnosed.

Hearing examination

In the subsequent hearing examination, a bilateral hearing loss is noticeable, which mainly affects the high frequencies. In speech, this means that especially sibilants and hard consonants can no longer be heard. This also leads to a very poor result in speech audiometry.

Therapy

The aging process can no longer be reversed. Therefore, the main therapy is to minimize the effects of the aging process.

Hearing aids

In the case of presbycusis, hearing aids usually have to be used on both sides. These are precisely adapted to the respective hearing deficits of the person affected. With the new devices, it is possible to achieve good hearing without disturbing background noise.

Accompanying training

However, accompanying training courses on targeted hearing should also be attended in order to be able to cope better with the hearing loss in everyday life. Learning to read lips can also be very helpful. And last but not least, the correct use of hearing aids must first be learned.

Adapting everyday life to hearing loss

In addition, the home can also be adapted to the new situation. There are, for example, amplifiers that increase the telephone volume and thus make telephone calls possible again. In addition, optical signal aids for doorbells or other warning sounds can be installed.

Particular importance should be attached to enabling integration in a group where care is taken to ensure that hearing loss does not lead to social isolation.

Forecast

Age-related hearing loss cannot be cured. However, the symptoms can be alleviated and a normal life can be restored. If the disease remains undiagnosed and untreated, this can lead to considerable social and psychological limitations.

Social withdrawal

Thus, reduced ability to communicate and discomfort in noisy settings leads to increasingly pronounced social withdrawal and isolation. At some point it simply becomes unpleasant and annoying when you only understand half of what is being said and have to ask several times.

Psychological stress

Of course, this also leads to a high psychological strain. Distrust and depressive moods often occur, which are promoted by several factors with increasing age. In addition, anxiety can also occur because one can no longer perceive warning signals at an early stage. Sooner or later, the withdrawal and limited communication also lead to premature mental decline.

To avoid all this it is absolutely necessary to consider an adequate therapy.

Editorial principles

All information used for the content comes from verified sources (recognised institutions, experts, studies by renowned universities). We attach great importance to the qualification of the authors and the scientific background of the information. Thus, we ensure that our research is based on scientific findings.
Danilo Glisic

Danilo Glisic
Author

As a biology and mathematics student, he is passionate about writing magazine articles on current medical topics. Due to his affinity for facts, figures and data, his focus is on describing relevant clinical trial results.

The content of this page is an automated and high-quality translation from DeepL. You can find the original content in German here.

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