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Age-Related Hearing Loss (ARHL)

Seeds of a Growing Problem

The population of the U.S. is getting older. According to the Administration on Aging, the aging ‘baby boom’ generation will produce a dramatic increase in the population through 2030. In 2009, people over 65 represented 12.9% of the population, but by 2030, they will represent 19.3%. The population over 65 is expected to double between 2008 and 2030 to a projected 72.1 million.

Why should we be concerned with an Aging Population? Because Hearing loss is the third most common chronic health condition among older adults! According to the National Institute on Deafness and Other Communication Disorders (NIDCD), 36 million Americans have impaired hearing, including 17% of our adult population. The occurrence of hearing loss increases with age. Approximately one third of Americans between 65 and 74 and nearly half of those over 75 have hearing and communication problems.

The Symptoms and Progress of ARHL

ARHL (also known as presbycusis) is a gradual and progressive hearing loss that affects most individuals as they age. Due to the slow progression, adults with ARHL may not realize that their hearing is diminishing …but if they do …they may accept it as normal aging. ARHL has a serious impact on the elderly because it diminishes their ability to communicate and reduces their functional independence. This limits their opportunities to participate effectively in their daily lives.

To those with ARHL, sounds often seem less clear and lower in volume. Muted murky sounds make it increasingly difficult to hear and understanding speech. Individuals with ARHL may experience several of the following:

  • The speech of others may seem mumbled or slurred.
  • It may become difficult to distinguish high-pitched sounds such as “s” and “th”.
  • Conversations become difficult to understand, especially when there is background noise.
  • A man’s voice may become easier to hear than the higher pitches of a woman’s voice.
  • Certain sounds may seem annoying or too loud.
  • Tinnitus (a ringing, roaring, or hissing sound in one or both ears) may develop.

Is ARHL the Same for Men and Women?

ARHL typically begins with high frequency hearing loss (degeneration of the hair cells lining the bottom of the Cochlea) and later affects the lower frequencies (apex of the Cochlea) as well. Paradoxically, several research studies indicate that while men develop high frequency hearing loss with age, women tend to have more problems discerning lower frequencies (250-1000Hz), possibly due to biologic factors such as hormones, or cardiovascular disease events (CVD) such as hypertension, coronary heart disease, stroke, and diabetes. While low-frequency hearing loss is related to CVD events in both genders, women tend to show this relationship more than men on audiograms. The figure (above) shows the gender reversal pattern, using average audiograms of 341 males and 346 females aged 50-89 years (Journal of the American Academy of Audiology (1993;4:42-49).

Although precise causes for this pattern require more research, the bottom line is that women with ARHL have more problems with low-pitched vowel sounds (o, a, ah, i, e), and men have more problems with high-pitched consonant sounds (d, t, sh, s, f, th). Since the softer high-pitched consonant sounds carry the meaning of speech, those (especially men) with pronounced high-frequency hearing loss often have problems understanding what is being said, especially in an environment with background noise.

About the Author

Dr. Li-Korotky is a nationally acclaimed research scientist and clinician, and the President of Pacific Northwest Audiology in Bend OR. The Doctor earned an MD with an emphasis in otology and otolaryngology, a PhD in audiology with a thesis on Age-Related Hearing Loss, and a Clinical Doctor of Audiology degree (AuD).