Roll nos.

9, 10

Hearing Loss in
Elderly
 Definition

• Hearing loss or impairment is when an individual

loses the ability to hear in either one or both ears.
The level of impairment can vary from mild to
severe or total loss of hearing.
• It can be caused by noise, ageing, disease, and
heredity.
 Epidemiology

Approximately 1 in 3 people between the ages of 65 and 74 has hearing loss and
nearly half of those older than 75 have difficulty hearing.

Hearing loss is the third most prevalent condition in older adults.

There are 16.45 crores persons above 65 years with disabling hearing loss (30% of
the world’s population above 65 years.)

Over 5% of the world’s population has disabling hearing loss. It is estimated that
by 2050 over 90 crore people will have disabling hearing loss.
Signs of hearing loss

• Trouble hearing over the telephone

• Find it hard to follow conversations when two or more
people are talking
• Often ask people to repeat what they are saying
• Need to turn up the TV volume very loud
• Have a problem hearing because of background noise
• Think that others seem to mumble
• Can't understand when women and children speak to them
• Having trouble hearing in a noisy background like in a
restaurant
• Complaining of dizziness, pain, or ringing in their ears
Presbycusis

It usually manifests at 65 years

Age-associated hearing loss is
but may do so early if thereis
associated with ageing process in
Hereditary predisposition or
the ear.
Generalised vascular disease
Types of Presbycusis

• Sensory – Degeneration of organ of corti (starts

at basal coli and progresses to apex). Higher
frequencies are affected
• Neural – Degeneration of cells of spiral
ganglion. High tone loss with poor speech
discrimination which is out of proportion to the
pure tone loss.
• Strial/Metabolic – Atrophy of striae vascularis
in all turns of cochlea. Physical and chemical
processes of energy production ae affected.
Speech discrimination is good. It often runs in
families.
• Cochlear conductive – Stiffening of basilar
membrane that affects its movements.
Symptoms

• Other people's speech sounds mumbled or

slurred.
• Having trouble hearing high-pitched sounds
• Having trouble understanding conversations,
often when there is background noise
• Men's voices are easier to hear than women’s
• Some sounds seem very loud and annoying
• Tinnitus in one or both ears
 Diagnosis

More often involving high No gap between air and bone

Loss may exceed 60dB
frequencies conduction curve on audiometry

Otoscopy to visualize external ear

canal for blockage, impacted ear
There is difficulty in hearing in Pure Tone Audiometry - to identify
wax, infection and to check if
presence of noise degree of hearing loss
tympanic membrane is perforated or
intact

MRI - to check for vascular

Tympanometry - to assess tympanic
anomalies, tumours or any structural
membrane and middle ear function
problems
Treatment

• Presbycusis is not curable. However, the effects of disease on

patients’ lives can be managed-
• Amplification devices
• Properly fitted hearing aids
• Older patients with arthritis and visual difficulties need extra
help in learning to use hearing aids
• Patients using hearing aids may still experience difficulties
with speech discrimination in noisy situations
• Assistive listening devices - Range from amplification of
telephone signal to sound transmitters
• Cochlear implants - Patients with cochlear changes and intact
spiral ganglia and central candidates are the best candidates
Thank You