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The Consequences of Age-Related Hearing Loss
Brooke Resch, Undergraduate in Communication Sciences & Disorders
ABSTRACT
CAUSES OF AHL
HEARING WITH AHL
With Baby-boomers entering retirement, age-related deficits of all kinds are
increasing in prevalence, warranting the attention of the general public. One such
deficit—hearing loss—is often overlooked and treated lightly by those afflicted with
it, despite the evidence showing that it has profound effects on quality-of-life1,2,14.
The purpose of this literature review was to evaluate the findings of several
studies pertaining to Age-Related Hearing Loss (AHL) and consolidate them to
better explain the major etiologies and symptoms of AHL. Making information on
AHL more accessible and understandable to the general population is important
because of the high prevalence of AHL and common misconceptions about it. The
review addresses some of these misconceptions including preventative measures
against AHL, the experiences of living with AHL, and available treatment options for
it.
Many recent studies have tested the effects of AHL in several aspects of the
sufferers’ lives. The results have shown that these effects are pervasive. The body of
work on AHL has demonstrated cognitive, communicative, and social challenges
associated with this condition. Fortunately, additional sources have a consensus on
which therapies and assistive devices are most effective in helping patients cope with
their AHL and treat their symptoms.
Biological processes associated with typical aging
contribute to AHL1. These processes occur mostly at the
cochlea—the hearing organ in the inner ear. Death of inner
hair cells and the stiffening of the basilar membrane on this
organ lead to poorer hearing in older adults.
These changes in the inner ear can be exacerbated by
excessive noise exposure over time3,6,8,9. Individuals who live
in urban areas or who work with loud machinery are,
therefore, more likely to experience hearing loss as they
age3,9. Twenty-percent of America’s workforce are routinely
exposed to noise levels that put them at risk for developing a
hearing loss3. Outside of work, the popularization of MP3
players has also been linked with earlier onset and a greater
prevalence of AHL9.
Drugs which are known to cause hearing loss are
considered “ototoxic”, many of which kill the hair cells of the
Ave. hearing loss from aging (without the effects of occupational noise) Data from National Association of Noise Control Officials
Although the entire speech spectrum of frequencies is impaired by AHL, not all
inner ear. Because AHL is primarily a result of hair cell
death, and older populations of people tend to have more frequencies are treated equally5,8. The disproportionate loss of high-frequency sounds
prescriptions for ototoxic drugs, the use of such drugs is can distort speech and make it more challenging to listen to speakers with higherpitched voices, like women and children5.
considered a cause of AHL10,12.
Additionally, people with AHL have a hard time discriminating between the
desired signal and background noise1. Difficulties focusing on just one sound leads to
communication breakdowns, especially in noisy environments.
AHL is typically bilateral and can greatly impair one’s ability to understand speech2. Because they are embarrassed about their hearing loss,
13
AHL sufferers will often pretend to understand something that they couldn’t hear . This typically leaves the hearing-impaired person in the dark
and the hearing person frustrated (as their partners often won’t laugh at their jokes or follow instructions) 14. Added to these mutual frustrations is
fatigue. A recent German study found that people with slight-to-moderate hearing losses considered conversations challenging “half of the time” 1.
Hearing loss due to aging is highly prevalent, and its incidence is only expected to
This means that half of time, people with AHL need to focus harder on what they are trying to listen to. This extra energy ultimately leads to
increase.
Despite this, the general public has a poor appreciation for the social,
fatigue.
4,7
emotional,
and cognitive consequences of AHL. These repercussions are, however, felt
Unsurprisingly, having AHL is associated with social isolation and with relationship strain . Between the social isolation and the negative self10
to
the
fullest
extent by people who suffer from AHL. Fortunately, amplification devices
image, many AHL suffers experience emotional problems including depression, stress, and loneliness . Those with
1
and
behavioral
modifications offer the chance to restore both hearing and relationships
moderate-to-severe hearing losses were eight times more likely to develop these emotional problems .
that might otherwise be negatively affected by AHL. Unfortunately, sociallyHearing loss is also associated with poor cognitive function as measured by both verbal and nonverbal tests11.
constructed stigmas about hearing loss keep many individuals from seeking these
People with AHL especially struggle with working memory10. The mechanism for what links hearing losses to
treatments. It is important that these stigmas are overcome in order to provide
cognitive declines is yet unknown.
appropriate care to anyone with AHL. Currently, a small fraction of those with this
condition actually seek help for it. Because of this, AHL continues to take more than
just hearing away from millions of victims.
CONSEQUENCES
DISCUSSION
TREATMENT AND COUNSELING
There are many options for treating AHL and improving quality-of-life after diagnosis, although
some have proven more successful than others.
Hearing aids are the most common treatment for AHS. They have been shown to improve both
pure-tone thresholds and speech comprehension5. Users report an improved quality of life after
receiving their hearing aids, and studies show that people with hearing aids are happier and have
better cognitive functioning than their AHL counterparts that don’t wear hearing aids1. Still, only
twenty-percent of people with AHS seek help, and among those with hearing aids, twenty-four
percent never wear them10.
In lieu of or in addition to hearing aids, many individuals with AHL could benefit from
specialized counseling or behavior modifications. Research has shown that people who
acknowledge their hearing loss are perceived as more friendly and approachable than those
who do not4. Teaching people how to talk about AHL could help them maintain their social lives
by improving other people’s perceptions of them.
Several conversation techniques have been recommended for people with AHL and their
partners. Facing each other, using visual cues, speaking slowly, and talking in a quiet
environment typically improve understanding in conversations. Ineffective conversation
techniques include shouting2,7.
REFERENCES
1Arlinger,
S. (2003). Negative consequences of uncorrected hearing loss--a review. International Journal of Audiology, 42, 17-20.
(2011). Age-Related Hearing Loss. American Speech-Language-Hearing Association.
http://www.asha.org/uploadedFiles/AIS-Hearing-Loss-Age-Related.pdf
3ASHA. (2014). The Prevalence and Incidence of Hearing Loss in Adults. American Speech-Language-Hearing Association.
http://www.asha.org/public/hearing/Prevalence-and-Incidence-of-Hearing-Loss-in-Adults/
4Blood, I. , Blood, G. , & ELSEVIER SCIENCE, I. (1999). Effects of acknowledging a hearing loss on social interactions. Journal of
Communication Disorders, 32(2), 109-120.
5Churchill, F. (2010). Retiring on a High Note. Hear-it. http://www.hear-it.org/Retiring-on-a-High-Note6Ehlers, J. , & Graydon, P. (2011). Noise-induced hearing loss in agriculture: Creating partnerships to overcome barriers and educate the
community on prevention. Noise & Vibration Bulletin, 127-128.
7Gomez, R. , & Missouri, S. (2001). Coping-with-hearing-loss model for older adults. Journals of Gerontology Series B: Psychological
Sciences & Social Sciences, 56B(4), .
8Kujawa, S. , Liberman, M. , NEUROSCIENCE, S. , & Duncan, J. (2006). Acceleration of
age-related hearing loss by early noise exposure: Evidence of a misspent youth. Journal of Neuroscience, 26(7), 2115-2123.
9Lewis, R. , Gershon, R. , & Neitzel, R. (2013). Estimation of permanent noise-induced hearing loss in an urban setting. Environmental
Science & Technology, 47(12), 6393-6399.
10Li-Korotky, H. (2012). Age-related hearing loss: Quality of care for quality of life. Gerontologist,52(2), 265-271.
11Lin, F. (2011). Hearing loss and cognition among older adults in the united states. Journals of Gerontology Series A: Biological Sciences
& Medical Sciences, 66A(10), 1131-1136.
12CDC National Institute for Occupational Safety and Health (2013). Occupational Hearing Loss (OHL) Surveillance. Centers for Disease
Control and Prevention. http://www.cdc.gov/niosh/topics/ohl/
13Targeted News (2012). Older Americans’ untreated hearing loss can lead to depression, social isolation. Targeted News Service.
14Yorgason, J. (2003). Acquired hearing impairment in older couple relationships: An
exploration of couple resilience processes. Dissertation Abstracts International, A: The Humanities and Social Sciences, 64(2), 679.
2ASHA.