Combating Hearing Loss Due to Aging
Many older adults struggle with hearing problems. The more you age, the more difficult it may be to understand what other people are saying or hear what is happening around you. There are many things that can cause this sort of hearing loss, including exposure to loud noise, underlying health conditions, or genetics. Hearing loss can disrupt daily life and make it more difficult to carry out certain tasks. Luckily, there are steps you can take to prevent and treat hearing loss as you get older.
Age-Related Hearing Loss: The Basics
Although we often don't realize it, changes in our hearing begin early in life. About 1 in 8 children and teens have been exposed to enough loud noise to cause permanent hearing loss. The older people get, the more likely they are to experience permanent damage:
- About 1 in 3 people aged 65-74 have hearing loss
- About 1 in 2 people over the age of 75 have hearing loss
Types of Hearing Loss
Hearing loss is classified based on which area of the ear is affected. The ear is divided into three main areas: the outer, middle and inner ear. When sound waves hit the outer ear, they create movements that travel along these three areas, eventually creating vibrations in the inner ear. Then, a nerve sends information about the sound from the inner ear to the brain. Any part of the ear along this path may become damaged or may not work correctly, leading to different types of hearing loss.
Hearing loss generally falls into four main categories:
- Sensorineural hearing loss happens when there is a problem with the inner ear or with the nerve leading from the ear to the brain. This type of hearing loss is permanent.
- Conductive hearing loss occurs when there is a problem with the outer or middle ear that prevents sound waves from getting through. This type of hearing loss may improve after treatment.
- Mixed hearing loss is a combination of sensorineural and conductive hearing loss.
- Auditory neuropathy spectrum disorder is the name for a condition in which the brain can't properly communicate with the ear in order to understand sound.
Age-related hearing loss usually falls under the category of sensorineural hearing loss. When hearing loss is connected with aging, it is known as presbycusis. In this condition, hearing gradually decreases over time in both ears. The amount of hearing loss may be mild, moderate, or severe.
Hearing Loss Symptoms
In some cases, it may be perfectly clear that you are experiencing changes in your hearing. You may realize that you have a harder time understanding words and sounds than you used to. However, because hearing loss can come on very gradually, it's also possible to have hearing loss without knowing it. Some of the symptoms of hearing problems include:
- Asking people to repeat themselves frequently
- Preferring to have one-on-one conversations, because you have difficulty talking to multiple people at once
- Experiencing difficulty with phone conversations
- Disliking background noise, or very loud noises
- Having other people complain that your music or your TV is too loud
If you or a loved one is experiencing these signs, it is probably a good time to check in with your doctor.
Why is Hearing Loss a Problem?
Hearing problems can make life more difficult in quite a few different ways. People with hearing loss may have trouble with:
- Hearing the phone or a doorbell
- Following warnings or smoke alarms
- Listening to a doctor's recommendations
Hearing problems can also translate into mental health struggles. Because hearing loss can make it difficult to have a conversation, people experiencing this condition may isolate themselves from others. Feeling uncomfortable, embarrassed, or discouraged is also common. Some people with hearing loss develop depression as a result.
People with hearing loss are also more likely to have problems with brain function, including with memory and focus. Those who have hearing loss are also more likely to have dementia.
Combating the Causes of Hearing Problems
There are many things that can cause hearing loss. Minimizing or addressing these factors can help you preserve your hearing and prevent further hearing loss, even if you've already started to experience some hearing problems.
Exposure to Noise
Being around loud noises permanently harms your hearing. Loud sound can damage structures in the inner ear called hair cells. Hair cells are not actually hairs – they are long, thin cells that sense sound vibrations. When these cells are damaged, they can die. The body can't make new hair cells, so once you lose the ones you have, your hearing gets worse.
Noise-induced hearing loss can develop after lots of repeated exposure to loud sounds. These sounds may come from machinery, such as tools at a woodworking shop or construction site. They may also come from listening to music loudly with headphones in or from attending loud concerts. Noise-induced hearing loss can also come from a single exposure to a very loud sound, such as an explosion. In this case, hearing loss occurs immediately.
You can protect yourself from noise-related hearing loss by doing things like:
- Noticing the things in your environment that create loud noises. This may include heavy machinery, music, snowmobiles, lawnmowers, or power tools.
- Taking steps to eliminate or reduce the time you spend around these sources of loud sounds.
- Lowering the volume on these loud sounds whenever possible.
- Wearing earplugs or other equipment to protect your hearing when you can't avoid being around loud noises.
Blockage of the Ear by Earwax or Fluid
Sometimes, hearing loss is a temporary problem caused by earwax or fluid in the ear. Earwax helps protect the ear from germs, dust, and water, but when too much of it builds up, it can cause hearing loss. People with this problem may feel like their ears are plugged, and may experience ear pain or a ringing sound in the ear.
Trying to clean earwax out of your own ear with a cotton-tipped swab is not recommended – you may push the earwax in, further blocking your ears. Instead, use baby oil, mineral oil, or over-the-counter earwax drops to soften the wax, and then try to gently wash it out with water. If these strategies don't work, your doctor can help safely remove extra earwax.
The eardrum is a thin membrane that helps you hear. It lies in between the outer ear and the middle ear. Sometimes, the eardrum can be pierced, creating a hole, which can cause ear pain or fluid leaking out of the ear. Causes of an eardrum puncture include pressure in the ear, very loud sound, infections, or sticking things in the ear, including cotton-tipped swabs. In some cases, the eardrum may heal on its own. Other times, the eardrum may have to be fixed with a procedure performed in the doctor's office.
Underlying Health Conditions
Sometimes, hearing loss can be a symptom of an underlying health issue, such as:
Getting regular physical exams can help you notice these issues early and address them. If you have symptoms of any of these other medical conditions, talk to your doctor to see if there may be something more serious going on.
Just as hearing loss can be a symptom of a health condition, it can also be a side effect of medications used to treat these conditions. Treatments for conditions like cancer, heart disease, or infections may sometimes cause hearing loss. Sometimes, these hearing problems are permanent, but other times, your hearing may get better after you stop taking the medication. If you think your hearing has changed since beginning a new medical treatment, talk to your doctor to see if your medication may be the cause. Don't stop taking a treatment without first talking to your doctor.
Genes help determine most of the characteristics that make up who we are. Genes are passed down from parent to child. Some genes have been linked to certain types of hearing loss, so if your parents had hearing problems when they got older, you may be more likely to experience these issues yourself. This type of issue can't be prevented, but treatments may exist to help people with these conditions.
What to Do If You're Struggling With Hearing Loss
If you think you're experiencing hearing loss, it's important to try to take steps to solve the problem. If you ignore it, your hearing may continue to get worse. Luckily, there are treatments that can help, including hearing aids and other devices. Which treatment is right for you may depend on the cause of your hearing loss.
Hearing aids can help many people hear better. They increase the volume of the sounds around you so that you can pick them up more easily. Nearly 30 million adults in the United States have some degree of hearing loss that could be helped by hearing aids. However, only 1 in 3 older adults who could benefit from a hearing aid has tried one.
Hearing aids are battery-powered devices that make sounds seem louder. There are multiple different types of hearing aids, but most fit inside or behind your ear. Many times, you can try out a device before you commit to it, which can help you make sure you find a hearing aid that fits well and works for you. You get traditional hearing aids from a hearing professional such as an audiologist.
If your hearing loss is not that bad, you may soon be able to get an over-the-counter hearing aid. These devices are not yet available, but will likely be sold in stores soon.
Other Medical Devices
If your hearing loss is severe, you may be able to get a cochlear implant. This device is placed inside of and behind your ear during surgery. It picks up sounds and directly sends information about these sounds to the nerve that runs from the ear to the brain. Hearing with a cochlear implant doesn't sound the same as normal hearing, but it may help you better understand noises and speech.
Other devices may be available, depending on what type of hearing loss you have. Implantable middle ear hearing devices (IMEHD) can be attached to small bones in the middle ear and help them work better. Another possibility is a bone-anchored hearing aid (BAHA), which is attached to your skull behind your ear. The BAHA will carry noise vibrations from the skull to the inner ear.
Assistive Listening Devices
Assistive listening devices, or ALDs, include a wide range of technology that helps people listen more clearly. These tools are often used to make sounds louder while in public places or areas with background sound, such as a meeting, auditorium, theater, or house of worship. For example, an ALD may consist of a microphone placed near a speaker or other sound source, and a receiver that is carried by a hard-of-hearing person or connected directly to a hearing aid. ALDs may also include phone amplifiers or smartphone apps that help people hear or understand the sounds around them.
Improving Your Conversations
If you're dealing with hearing loss, it's probably more difficult for you to talk with others. You can let other people know in advance that you have trouble hearing in order to make it easier for both of you to communicate with each other. Ideas for how to have better conversations include:
- Ask people to speak more loudly, clearly, or slowly
- Ask people to repeat themselves, or have them reword what they were trying to say
- Request that people directly face you when speaking to you
- Notice your conversation partner's body language and facial expressions in order to get a better idea of what they are communicating
- Try to have conversations in places without a lot of background noise, or turn off background noises like the TV or radio while listening
- If you're in a group of people, ask others to speak one at a time
The first step in addressing hearing problems is talking to a doctor. Having an appointment with your primary care provider may be all you need in order to address the issue. Other times, your primary care provider may refer you to an ear, nose and throat doctor, also called an otolaryngologist. You may also need an appointment with an audiologist, who can provide hearing tests and treatments. Addressing hearing loss often makes life more easy and enjoyable, and may even lead to other health improvements!