Age-Related Hearing Loss

Bob, 84, has been living alone since his wife died five years ago. About two years ago, he began losing his hearing. Bob got hearing aids and has managed to live alone in his home with his dog.

Bob has suffered an asthma exacerbation and was hospitalized for a few days. His nurse noticed that he appeared to be a little confused before he was discharged. Bob underwent cognitive and memory testing. Some deficits were identified, but Bob attributed them to his inability to hear well.

Recently, a neighbor called Bob’s daughter, Nancy, and reported her concerns about Bob. He has been outside walking aimlessly in the evening. Nothing serious, but enough that she thought Nancy should know about her concerns.

Nancy, who lives in Europe, returned home to check on her dad. She will complete a two-year job commitment in six months, but she is concerned about her father’s ability to care for himself in the meantime.

What percentage of people over age 65 have hearing loss?

Approximately one in three people between the ages of 65 and 74 have age-related hearing loss. Nearly half of people over the age of 75 have difficulty hearing. Age-related hearing loss typically affects both ears, affects high-frequency sounds first, and slowly progresses. For this reason, it’s hard to tell that hearing loss has occurred.

What are the three types of hearing loss?

Sound travels through the external ear canal and vibrates the eardrum, a thin membrane that separates the outer ear from the middle ear. Next, the vibration is transmitted and amplified by three small middle ear bones. The last in the series of three bones abuts a membrane that divides the middle and inner ear.

Finally, the vibrating middle ear bone starts a fluid wave in the inner ear. The fluid wave bends nerve fibers in a particular pattern for each frequency, which the brain interprets as sound. Any obstruction along this pathway or damage to the nerve fibers results in hearing loss.

Sensorineural Hearing Loss

Sensorineural hearing loss occurs when the nerve fibers in the inner ear are damaged. It is the most common type of hearing loss. It can come on suddenly and needs prompt treatment. Depending on the cause, corticosteroids may be prescribed to decrease inflammation in the inner ear.

Potential causes of sensorineural hearing loss include:

• Aging
• Exposure to loud noises
• Head injury
• Infection
• Disease
• Exposure to certain drugs
• Inherited medical conditions
• High blood pressure
• Sudden changes in air pressure

Conductive Hearing Loss

Conductive hearing loss occurs in the outer or middle ear and is due to a problem transmitting sound waves from the outer ear to the inner ear.

In the outer ear, earwax or a foreign body may block sound waves from striking the eardrum. In the middle ear, fluid may collect and keep the middle ear bones from vibrating. Damage to the middle ear bones or a congenital anomaly can also cause hearing loss. For example, otosclerosis is an abnormal growth in the middle ear that keeps the bones from vibrating. A cholesteatoma is a growth of noncancerous tissue in the middle ear.

Temporary sources of conductive hearing loss include:

• Ear wax
• Foreign objects
• Excess fluid in the middle ear from allergies or congestion
• Middle ear infections
• Otitis externa or swimmer’s ear from water sitting in the external ear canal

Mixed Hearing Loss

Hearing loss is considered mixed when there is a combination of both sensorineural and conductive hearing loss. An example of mixed hearing loss may be sensorineural hearing loss due to damage to nerve cells from loud sounds combined with fluid in the middle ear from an ear infection.

What causes sudden hearing loss in older adults?

Sudden hearing loss is a medical emergency because early treatment frequently leads to a better outcome. Each year, about one in 5,000 adults experiences a sudden onset of hearing loss. Males and females are equally affected. The average age of sudden hearing loss is in the mid-40s to mid-50s.

Potential causes of sudden-onset hearing loss include:

• Bacterial or viral infections such as measles, mumps, and streptococcus
• Inner ear disorders such as Meniere’s disease, which causes dizziness and ringing in the ear
• Migraines
• A side-effect of some medications such as aminoglycoside antibiotics, long-term aspirin use, loop diuretics, and chemotherapy drugs
• A neurologic condition such as multiple sclerosis
• Head injury
• Autoimmune disorders such as rheumatoid arthritis, in which the immune system attacks self-tissue
• Decreased blood supply to the middle ear due to circulation problems
• A loud noise such as an explosion

Sudden-onset hearing loss can be disorienting and a significant stressor that may uncover mood disorders or memory problems that people have been able to compensate for until they lose their hearing.

Bob has been living alone with moderate hearing loss. He has had a recent illness and a hospitalization at which they discussed concerns with his memory. Bob will undergo further hearing tests to see if his condition has worsened. In the meantime, Bob and Nancy need a solution to help keep Bob safe and comfortable in his home until Nancy completes her work assignment.

Contact us for help

What could happen if hearing loss is not treated?

If sudden-onset hearing loss is not treated, the hearing loss may be permanent.

What treatment is available for hearing loss?

There are several options available to improve hearing for people with partial to severe hearing loss, including:

• Hearing aids: For those with mild-to-moderate hearing loss, hearing aids may be a good option. There is a wide range of hearing aid options available depending on the severity of your hearing loss, lifestyle preferences, and budget.
• Cochlear implants: Cochlear implants may be a good option for those with severe or profound hearing loss. Cochlear implants are surgically implanted behind the ear to assume the function of the cochlea.
• Assistive listening devices: These devices are used to amplify sound. They can be used along with a hearing aid.

Can hearing loss be prevented?

Hearing loss cannot always be prevented. Aging, genetic predisposition, and damage to the ear are commonly not reversible. If you have a family history of hearing loss, you may be at a higher risk.

To prevent age-related hearing loss, wear protective sound-canceling headphones when exposed to loud noises and moderate the volume on the television and other audio devices to decrease your exposure to loud noises.

Chronic health conditions such as high blood pressure and diabetes can increase your risk of hearing loss. Eating a healthy diet, maintaining a healthy weight, engaging in exercise, and monitoring your blood sugar and blood pressure can decrease your risk of these chronic diseases.

Ask your doctor if any of your medications increase your risk of hearing loss. If so, ask if there are any alternative treatment options.

How Sunland Home Care & Medical Can Help Reassure Geographically Distanced Family Members

Nancy contacted Sunland Home Care & Medical to arrange for daily in-home services and a fall risk assessment. She is concerned that Bob may be at an increased risk for falls due to his inner ear disease. Nancy arranged for caregivers to come to Bob’s home daily to help him with his meals, home maintenance, and personal care. She also arranged for a Sunland registered nurse to do a fall and balance assessment and wellness checks once a month for the next six months. Now, Nancy can return to her overseas job comfortable that Bob has the support he needs and that she will be notified if there are any changes in his condition.