Loss of hearing or hearing impairment is caused usually by exposure to loud noise, ageing, effects of diseases and heredity issues. People with hearing loss find it difficult to have conversations with friends and family. This can lead to their social isolation and may result in a depressed community life.
Old people with hearing difficulty have trouble understanding doctor’s advice, responding to warnings and hearing doorbells and alarms. Timely diagnosis and treatment such as ear cleaning, surgery or use of hearing aids can help in majority of cases.
Hearing loss problem in the World
As per World Health Organisation (WHO), over 5% of the world’s population (360 million people) have loss of hearing problem. Out of this, about 32 million are children.
As per WHO, 60% of hearing impairment in children can be prevented by immunization against diseases, controlling noise pollution and regulating use of certain medicines.
How much does India suffer from hearing loss?
As per last WHO studies, hearing impairment or loss of hearing is present in India to an extent of 6.3% of its population. This means that 63 million or 6.3 crore people are suffering from various degrees of hearing loss. This includes old age hearing issues which occur when we age significantly. Further, there are 50 lakh Indian children with hearing loss.
The percentage of adults who suffer from hearing problems later in their adult life is 7.6% while 2% of children have loss of hearing since birth or early childhood.
Findings by National Sample Survey (NSS) indicates that loss of hearing is 9% in urban areas and 10% in rural areas. We see that out of this, old age related hearing disability was reported to be quite high at 56 % and 62% in rural and urban areas respectively.
How do you know if you have hearing loss?
If you observe the following symptoms or behaviour in yourself or anyone in the family, it is time to check for hearing ability.
- Find it hard to follow conversations when you are talking with someone or in a group
- Find difficult to understand when women and children talk (they usually speak in a different frequency and speak softly)
- Frequently, you ask people to repeat themselves
- Need to increase TV or mobile sound system volume
- Have difficulty in hearing over land telephone or mobile
- Find it tough to understand in a noisy background
What are different types of hearing loss?
Loss of hearing problem can be of various degrees and types. This is determined during a hearing test. A mild difficulty in hearing means that you cannot hear a few high-pitched sounds, such as voices of women and children. Person with severe form of hearing impairment cannot hear many types of sound properly or may even have total deafness.
In medical terms, hearing loss is of two types:-
- Sensorineural hearing problem : This happens when the inner ear or auditory nerve is damaged. This may sometimes lead to permanent loss of hearing.
- Conductive hearing loss: This occurs when sound waves cannot reach inside of your ear, i.e. the inner ear. This can be due to a variety of reasons: earwax build-up, fluid blockage, damaged eardrum etc. Medical examination of the inner ear and necessary treatment can help.
The various causes of loss of hearing are detailed below:-
Exposure to loud noise on a regular basis is a common cause of hearing loss. This can be loud music, loud TV/ head phones, noise of machines at work place, vehicles noise etc.. All these can affect inner ear adversely, resulting in hearing impairment.
Too much of earwax accumulation can block sound waves from reaching the inner ear.
Damaged ear drum affects your capacity to hear. This can happen due to a number of reasons such as infection, pressure or impact from tools put inside the ear (such as ear buds)
Old people tend to suffer from hearing loss, especially if they also have conditions such as diabetes or high blood pressure. Heart diseases, brain injury or tumour can also result in loss of hearing.
Side effects of certain medicines may result in loss of hearing. These are called ototoxic drugs (i.e. drugs affecting ears badly) and often relate to medicines taken for serious diseases such as cancer, or heart diseases.
Heredity is an important factor causing loss of hearing in children. But it may often show up at a later adult stage.
In case of above issues, you would do well to consult a doctor for proper diagnosis and treatment/ medication.
What is age-related or old age hearing loss?
We all start to lose some of our hearing abilities when we are past the middle ages. About 1 in 5 adults suffer from age related hearing impairment. More than 50% of people aged over 80 years lose hearing ability. You may have experienced this in your friend and family circles.
Age-related hearing loss (Also called “Presbycusis”) is loss of hearing that gradually occurs when we grow older and older. It is one of the most common conditions affecting old and elderly adults.
Old age loss of hearing usually occurs in both the ears. Because this is gradual, you may not even realize that you are losing your ability to hear.
There are many causes of age-related hearing loss. Most commonly, it arises from physiological changes in the inner ear as we age. But it can also result from changes in the middle ear or changes in the nerve pathways from ear to the brain. Certain medical conditions and medicine side effects may also be responsible as mentioned earlier.
How does hearing loss affect old people?
Older people having loss of hearing often may become depressed. They stay away from others because they may feel embarrassed about not understanding the on-going conversation. They may feel socially isolated. In addition, we tend to misunderstand people with hearing disability as being non responsive.
Having trouble in proper hearing can also make it hard for old people to understand doctor’s advice, respond to warnings, and hear phones, doorbells or smoke alarms.
Old age or not, you should not ignore hearing problems, as they can become worse with time. You can consult with your doctor or a specialist, who may suggest proper ear treatment (or even surgery, based on severity) or suggest wearing hearing aids.
What can you do to prevent old age hearing loss?
Experts suggest that you can not cure or prevent age-related hearing issues completely. However, you can attempt to minimize its severity.
You should stay away from too noisy environments. Stay away from ear damaging noises such as loud music, bursting of crackers, running of noisy machines such as blowers, lawn mowers, noisy generators etc.
These small preventive measures can help you in better protecting your ear drums from damage at adult age, especially old age.
Method of diagnosis: how is hearing test done?
If you experience symptoms of hearing loss, age-related or other-wise, you may visit your family doctor to diagnose your condition. Your doctor may conduct tests to rule out other causes (such as diseases / associated medicines) of hearing problems.
He may also look inside your ears using an otoscope (instrument for looking inside the ear for any damage or blockage) for knowing visible blockage or damage.
If your doctor can’t find another cause of your symptoms, he may diagnose you with usual age-related hearing impairment. They may refer you to a hearing specialist such as an audiologist. The audiologist can perform a detailed hearing test to help determine extent of hearing loss.
Who is a hearing specialist or an audiologist?
Audiologists are specialised health care professionals who earn a masters or doctorate degree. They specialise in the profession of identifying, assessing and managing disorders of hearing and related neural systems. Audiologists are like optometrists (for eyes) who work with a number of tools to perform their job. They can perform elaborate ear cleaning procedures such as removing ear wax though vacuum suction process.
When you or anyone in the family has a serious hearing problem, you may see a general doctor or a specialised ENT doctor. Your doctor may further refer to an audiologist who can identify and measure the extent of hearing loss and may also suggest kind of hearing aids, if required, or other specific treatment.
What kind of hearing test is done?
Audiologists may conduct hearing tests to determine extent of hearing loss. During the test, different types of sounds are presented to the person’s ears.
When testing is done with earphones or loudspeakers, sound can travel through the ear canal; go up to the middle ear and then reach inner ear parts. This is called air conduction testing. This helps measure how well your entire hearing system is working.
Another kind of hearing testing is called bone conduction testing. A bone vibrator device is placed behind the ear to send sounds directly to the inner ear. This way sounds are sent through the bones of the head and do not pass through the eardrum or the middle ear.
Through the above two tests, ear experts or audiologists can figure out how good your hearing quality is or what kind of hearing loss may have occurred.
How to read an Audiogram?
A hearing test is conducted typically by an Audiologist. Results from this are charted on an audiogram. An audiogram is essentially a graph showing the kind of sounds with different pitches or frequencies (a range of from low to high) that you can hear. The audiogram here shows how different hearing results correspond to varying degree of hearing loss.
The closer the hearing test results are to the top of the graph, the softer and better the sounds that person can hear.
What is the treatment for hearing problems?
As of date there is no permanent cure for age-related hearing loss. If you have this, then your doctor may suggest you to improve lifestyle and help in improving hearing.
Typically, recommendations cover the following:-
- Wearing hearing aids to help you hear better
- Assistive hearing devices, such as telephone amplifiers
- Avoiding noise-prone environments or playing gadgets at high volume
- Learning lessons in sign language or lip reading (for severe or extreme hearing loss close to deafness)
Surgical implants such as cochlear implant may be recommended in certain severe cases of hearing disability. A small electronic device is implanted into your ear to make sounds louder. Cochlear implants however may not give you back normal hearing level.
What are hearing aids?
Hearing aids are small electronic devices which amplify sound and help person with less capacity to hear different sounds.
Most Hearing aids have certain similar components. Usually, these consist of a microphone which senses the sound, amplifier component which makes sound louder and a very tiny speaker, which conveys a louder sound to the ears of the person wearing the device. These devices operate on batteries, which you need to replace regularly.
Hearing aids vary based upon their design, amplification technology (analog vs. digital) and certain special features. Some hearing aids may come with special ear moulds or earpieces, which can help direct sound waves into the ear resulting in superior sound quality.
You should select your hearing aid based on type and extent of hearing loss, or as may be suggested by your doctor or ear specialist. Other factors can be your specific listening needs and lifestyle such as need for watching TV, mobile, need for talking on telephone, or social / family environment etc.
Age-related hearing loss is a common occurrence due to various reasons. If you feel you have difficulty in hearing, you may consult doctor and may start using assistive devices such as hearing aids to improve your family life.
Those with mild to moderate hearing loss may benefit from wearing hearing aids. After a thorough hearing evaluation, an audiologist will recommend the type and style of hearing aid according to the severity of your hearing loss, preferences and budget.
To prevent hearing loss or extent of it, you should stay away from factors such as exposure to loud noise, maintain ear hygiene, and avoid diseases such as BP or diabetes or related medicines with side effects.