Is Your Hearing Loss Normal?

October 17, 2011

118368697“What did you say?” That’s a frequent question we ask as we get older. To understand how hearing changes as we age, and what’s normal and what isn’t, let’s review how the ear works. The ears may be small but they’re quite powerful!


Believe it or not, it is actually tiny hairs inside our ears that allow us to hear. The outer portion of our ear catches sounds waves and pushes them down through the auditory canal. The hairs pick up the sound waves and change them into nerve signals that the brain interprets as sound. Different groups of hair cells are responsible for high versus low frequencies. Hearing loss occurs when the tiny hairs inside the ear die or become damaged. The problem is that unlike the hair on our head, hair cells in our ears do not regrow, so hearing loss is usually permanent.


Some hearing loss is a natural part of aging; we even have a medical word for it – presbycusis.  As we get older, several things happen: the tiny bones become less flexible, our auditory nerve becomes weaker and hair cells die. All of this causes hearing loss.


At first, it’s most difficult to hear high-frequency sounds, such as someone talking. A spouse or the child of an elderly parent will often comment that the television volume is quite loud. Or typically, the wife will tell me she has to shout at her husband or repeat what she has said to get a response. (I know, I know…hearing loss isn’t the only reason some husbands do not respond) As hearing gets worse, it becomes more difficult to hear sounds at lower pitches.


It’s important to know that most hearing loss does not become noticeable until we’re in our sixties. And it typically gets worse each decade after age 60. By the time we approach age 70, nearly half of us will have some hearing loss. And age-related hearing loss is typically in both ears, not just one. As you would expect, most of the loss of hearing occurs slowly over time.  Rapid or sudden hearing loss is never normal.


Heredity plays an important part in determining whether you will develop significant hearing loss. So if your parents and grandparents had hearing problems, you will be more likely to as well.


There are some other risk factors for hearing loss. If you had jobs where there was a lot of noise, you’re more likely to have hearing problems as you get older. Examples include construction workers or airplane mechanics. And it is true that if you blast the music in your ears through your headphones, you are likely causing damage that will manifest years later. 


Repeat ear infections can also cause hearing problems later in life. Diabetes, high blood pressure, osteoporosis and smoking can also cause hearing problems or make them worse. It’s important to watch your overall health to maximize how well you hear.


When evaluating hearing loss and trying to decide whether it’s a normal part of aging, I ask the following questions:

  • When did the hearing loss start?
  • How has it changed over time? Gotten better? Gotten worse?
  • How well can you understand conversation?
  • Is the problem with background noise or is there hearing loss in a quiet setting?
  • Is there any type of drainage from the ear?
  • Are you experiencing any ear pain?


Remember, normal hearing loss due to aging starts around our 60's, worsens slowly over time, is not painful and doesn’t cause any type of oozing from the ears. 


Hearing loss can be frustrating for both the person talking and the person listening. If you or a loved one has hearing loss, consider getting a hearing aid. Hearing aids have improved tremendously in the last five years; they’re no longer those large pieces hooked on the side of the ear. They also regulate sound much better with less interference. Too often, people with hearing loss become socially isolated because they’re embarrassed that they can’t hear. In addition, we now know that hearing loss can lead to dementia. It is important to have regular hearing tests to help prevent and deter these more serious conditions.


 Want to learn more about what your aging symptoms really mean? Check out Is this Normal? The Essential Guide to Middle Age and Beyond

 

More on Aging:

Aging IQ Quiz

5 Most Surprising Age-Related Changes

5 Myths About Your Aging

 

Photo Source: Thinkstock/istockphoto

 


John J. Whyte, MD, MPH is the Chief Medical Expert & Vice President for Continuing Medical Education where he develops, designs and delivers health programming.
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