Q: My wife, 76, is becoming more deaf as she ages. It is getting to the point where she misunderstands me all the time so conversation is difficult. I think she needs a hearing aid but she says she is fine. What can I do and what causes older people to become deaf? Does everyone get deaf as they age?
A: Not everyone gets deaf with age. My mother, who lived to be 97, had perfect hearing all her life. She got annoyed when nurses and helpers would speak slowly and loudly to her, assuming that she was deaf or demented.
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Health Canada reports that as many as 40 percent of people 75 and older have a significant amount of hearing impairment. Only arthritis and high blood pressure are more prevalent.
The medical word for age-related hearing loss is presbycusis. Presby means elder and cusis refers to hearing.
Heredity is one factor, but working or living in a noisy environment also adds to the likelihood of going deaf in later life.
Some medications can have a negative effect on parts of the brain that deal with hearing and understanding. Dietary deficiency of folic acid may also play a part. Otherwise it is just wear and tear or normal aging.
The two major types of presbycusis are sensory and strial. Sensory presbycusis is caused by the loss of outer hair cells in the inner ear and associated with a high frequency loss of hearing. It is easier for those afflicted to hear men’s voices than women’s, because they are lower.
Most people who have sensory presbycusis can hear speech but have difficulty understanding it. Their understanding of speech is impaired because it depends on high frequency hearing ability.
Strial or metabolic presbycusis isn’t as common as sensory presbycusis and affects low and high sound frequencies.
This type of hearing loss is caused by pathology of the stria vascularis, the source of electrical energy that drives the cochlea or inner ear. Strial presbycusis is more common in women than in men and has been linked to cardiovascular disease.
Neither type will lead to complete hearing loss and both are treatable with a hearing aid.
People with hearing impairment often have difficulty admitting to themselves or others that they have a problem. This is partly because the onset is so gradual that they may not notice and because no one wants to admit they are having difficulties.
Untreated hearing impairment can lead to social isolation and even paranoia. There may be a feeling that people are talking about them, which can lead to arguments.
The deaf person may be left out of important discussions and not invited to social events. Relatives and friends often mistakenly believe that the person is getting Alzheimer’s.
Hearing specialists can check hearing with audiometric tests. They can tell the difference between high tone and low tone deafness and recommend an appropriate hearing aid.
Clare Rowson is a retired medical doctor living near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor. She can be reached at health@producer.com.
