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Why Can't I Hear You Now? Age-Related Hearing Loss


Medically Reviewed On: January 23, 2004

By Christine Haran

If it suddenly seems like your daughter is whispering into the phone and your neighbors are banging on the wall for you to turn down your TV, you might have age-related hearing loss. Although it's often hard for people to admit to hearing loss, it affects one-third of Americans over age 60 and 40 to 60 percent of those over age 75.

It's important to see a doctor about your hearing loss so that the type and degree of hearing loss you have can be determined. The two most common types of hearing loss are conductive hearing loss, in which sound waves are blocked in the external ear canal or middle ear by, for example, an obstruction or inflammation, and sensorineural hearing loss, which involves damage to the inner ear nerves or hairs. Most older people have presbycusis, a form of sensorineural hearing loss that occurs gradually and affects the ability to hear high-frequency sounds such as children's voices.

Below, Suman Golla, MD, an assistant professor at the University of Pittsburgh School of Medicine, Department of Otolaryngology and a spokesperson for the American Academy of Otolaryngology, Head and Neck Surgery (AAOHNS), discusses how age-related hearing loss occurs and how you can learn to live with it.

What can cause hearing loss?
Damage to the outer, middle or inner ear. This can be from trauma, noise exposure, medication, autoimmune or metabolic disease conditions, tumors that are benign or malignant, or age-related changes. Just as with other organs and organ systems, there's degeneration of cells and nerves as we age.

What factors increase risk for developing age-related hearing loss?
In addition to the degeneration related to age, there's also noise exposure through the years and diseases of the ear that affect the middle ear like otosclerosis, which is the fixation of the ear bone, or Ménière's Disease. If you've had had a long-standing history of a chronic draining ear, which is called chronic otitis media, that will affect your chances of developing loss.

And of course, genetic background and general health will also affect the degree of hearing loss.

There are certain medical conditions that may affect your hearing loss such as diabetes and high blood pressure. Now, all the studies demonstrating this effect aren't excellent, controlled studies, but there is some thought, with diabetes for example, that the narrowing of blood vessels that occurs can compromise the blood flow in the ear, as it does in other organs, such as the kidneys and the eyes. With high blood pressure, it's not as clear-cut, but the thought is that anytime there's decreased blood flow to the inner ear, you can have some damage to your hearing.

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