Hearing Loss in the Elderly

• When elderly individuals experience unclear hearing, missing some words, not hearing entire sentences, having ringing in the ears, frequently asking conversation partners to repeat themselves, watching television at a higher volume than usual, or speaking louder than normal, they should see a doctor for a hearing test.
• Chronic diseases such as diabetes, high blood pressure, high cholesterol, and certain medications may accelerate the deterioration of the auditory nerve.
• Currently, no medication can reverse age-related auditory nerve degeneration. If hearing loss significantly affects daily life, hearing aids may be used. In severe hearing loss or deafness cases, doctors may perform cochlear implant surgery.

One problemamong the elderlyis hearing loss caused by gradual degeneration of the inner ear’s auditory nerve as age increases. Although hearing loss in older adults is less dangerous than other serious illnesses, it greatly impacts daily life and can cause communication problems between caregivers and the elderly. This may lead to misunderstandings about medication or self-care, worsening existing chronic conditions, or social withdrawal due to lost confidence, potentially resulting in stress and depression.

Causes of hearing loss in the elderly

Stem from the degeneration of the auditory nerve and hair cells in the inner ear with age. The hair cells at the base of the cochlea deteriorate first, causing older adults to lose the ability to hear high-frequency sounds. The degeneration gradually spreads to the mid-frequency range, which includes speech sounds, leading to unclear hearing. Symptoms typically begin around age 60. Chronic diseases and some medications may speed up auditory nerve degeneration, such as diabetes, high blood pressure, and high cholesterol. If untreated, hearing loss may progress to severe levels.

How severe does hearing loss need to be to be called hearing impairment?

Hearing loss is a reduction in hearing ability, with varying degrees of severity as follows:

Diagnosis of hearing loss in the elderly

• Consult a doctor for a physical exam, including history-taking, symptom observation, and initial hearing assessment.
• Detailed ear examination covering the outer ear, middle ear, and eardrum; in some cases, neurological and cranial nerve assessments may also be needed.
• Special tests such as audiograms evaluate the degree of hearing loss.

When should elderly individuals have their hearing tested?

• Frequently ask conversation partners to repeat themselves.
• Watch television at a louder volume than usual.
• Hear unclearly; some words are missing or sentences are incomplete.
• Have ringing or noise in the ears.
• Speak louder than usual.

Prevention and slowing the progression of hearing loss

• Avoid exposure to loud noises.
• Do not insert foreign objects into the ears except for medication prescribed by a doctor.
• If experiencing ear pain or discharge, consult a doctor immediately.
• Eat nutritious food and exercise regularly to prevent diseases such as hypertension, which can cause hearing loss.

Communication with elderly individuals with hearing loss

• Speak facing the person who has hearing loss.
• Do not wear face masks or other coverings that prevent lip reading.
• Speak in short, clear sentences.
• Use a clear voice but avoid shouting.
• Speak in quiet environments with minimal background noise, such as turning off the television.

Treatment for hearing loss

Since there are currently no medications for age-related auditory nerve degeneration, if hearing loss affects daily life, doctors may recommend hearing aids, which amplify sound and are worn in the ear and removable. In cases of severe hearing loss or deafness, cochlear implant surgery may be considered, where an implant is placed in the cochlea bone inside the inner ear.

If hearing loss from auditory nerve degeneration is just beginning, elderly individuals should take care to prevent further deterioration by regularly seeing a doctor tocheckhearing levels. They should avoid loud noises, control chronic diseases that increase risk, avoid using ear drops without medical advice, exercise regularly, eat a balanced diet, get enough rest, and maintain a positive mindset.

Information courtesy of Dr. Sawitree Chaloeyoo, Otolaryngology Specialist (Ear, Nose, Throat)Samitivej Srinakarin Hospital