Elderly Hearing Loss

It is true that along with the progress of age comes hearing loss for most people. The reason for this is that there is a gradual loss of the outer hair cells and to a lesser extent of the hair cells of the organ of Corti. This loss is more pronounced at the base of the cochlea which detects high frequencies that are important for clear hearing in the presence of noise in the background and less severe in the middle sections that trace the bulk of the sounds from the surrounding area, including speech.

These changes in the cochlea seem to start at birth and so there is a gradual loss of hair cells in all people, although the rate of loss varies for each person. It seems that humans have more hair cells than needed for an adequate hearing. Thus, the result of this progressive loss does not become perceptible until the individual reaches the fifth decade of their life. Then they meet difficulty hearing a conversation in the presence of background noise (for example, in a restaurant), because the loss of high frequencies makes it difficult to distinguish between different voices. The voice of each person is recorded with the help of a range of frequencies known as “frequency-makers” and the set of frequencies is what distinguishes this voice. The separation of a voice amongst other voices causes the brain to carry out an analysis of forms of speech and to distinguish this voice from the others around it. For this to happen the higher frequency-makers need to be heard, conditioners and significant loss of high frequencies must apply, otherwise something like this simply cannot happen.

Another feature that accompanies the loss of hair cells is called “recruitment.” In elderly hearing loss, hearing levels are reduced to such an extent that low sounds cannot be understood. When the volume reaches a level that is detectable, then there is a rapid rise in the level of intensity of sound perceived which very soon becomes annoyingly loud as the volume increases. The phenomenon of recruitment can practically be seen when, for instance, entering a room where there is an old family member of yours who cannot see you. You say “hi” with a normal tone of voice and they cannot hear you. Then you raise the tone of your voice, but they still cannot hear you. Raise the tone of your voice again and then they turn to you and complain: “Do not shout, I’m not deaf!”

Unfortunately there is still no cure or prevention method of elderly hearing loss. At present, what can only be done is to confirm that the person is not suffering from a curable disease of the ears and to offer all the necessary explanations, utilities from the surroundings and hearing aids if required or desired by the patient. The use of a hearing aid can be difficult when the support is very strong, so much that devices with some degree of electronic control of the finished audio product are often required for comfortable hearing. The user of the hearing aid needs to acclimate to the hearing aid using it a little at first and gradually increasing its use, to allow the ears and brain to accept all the new sounds that were not heard before.

However, some patients are impatient and expect an instant response from the hearing aid and are disappointed when the new sounds from an excellent hearing aid are not those to which they are accustomed. It is important that patients be tolerant.