As you get older, your hearing will become less sensitive. This can vary from person to person, and your hearing sensitivity may differ from those around you if onset starts earlier or later. Hearing loss can be triggered by exposure to loud noises, infections, injury, or hereditary predispositions.
Your ears are made up of three sections: the outer, middle, and inner ear. Tiny bones, tissue, membranes, canals, and nerves are inside your ear that work together to allow you to process sounds. Because these parts are small and delicate, they can be damaged or lose sensitivity as you get older.
Hearing problems normally develop gradually, making them hard to recognise in the beginning. Often the ability to hear higher frequencies is affected first. Hearing loss can also be embarrassing for some people to admit, and they begin to avoid social situations where they think they may not be able to hear or participate. It is important to remember that hearing loss can be treated and managed in many cases by seeing an audiologist.
Presbycusis - Age-Related Hearing Loss
Presbycusis, also called age-related hearing loss, is the most common cause of hearing loss. About one third of people over the age of 65 experience presbycusis, and it is estimated that the number of New Zealanders over the age of 70 experiencing presbycusis will double in the next 50 years.
Presbycusis is a sensorineural hearing disorder that can often be managed with hearing aids. Some of the symptoms include:
- Hearing other people’s speech as mumbled or slurred
- Having difficulty telling apart high-pitched sounds such as ‘th’ or ‘s’
- Struggling to understand or follow conversations, especially in noisy environments
- Finding it easier to hear or understand a man’s voice compared to a woman’s
- Finding some sounds too loud or annoying
- Ringing in the ears (tinnitus)
Presbycusis is caused by the natural ageing deterioration of the auditory system. Hearing is lessened by the loss of nerve hair cells in the cochlea. Some people may be more prone to developing worse presbycusis or having earlier onset. Factors triggering this may include:
- Hereditary aspects
- Environmental factors, such as repeated exposure to loud noises
- Smoking and alcohol
- Some medications
- Illnesses such as meningitis or untreated ear infections
- Physical trauma that damages the ear
In many cases, age-related hearing loss can be treated and managed with hearing aids that are fitted by an audiologist. These are customised to suit your individual hearing loss and hearing needs. These may separate voices from background noise and amplify voices close to you.
Wearing hearing aids is like wearing glasses and will become a normal part of your routine. There are different designs for hearing aids that include behind-the-ear, completely-in-the-canal, and bone-anchored hearing aids to best suit your needs. Your audiologist will work with you to find a design that works best for you.
Some other treatments for more severe hearing loss may include cochlear implants, hearing implants, or other methods of communication such as learning how to lip read or to use sign language.
Hearing aid funding in New Zealand can be subsidised by the government. You may be eligible for the Hearing Aid Funding Scheme or the Hearing Aid Subsidy Scheme. The Subsidy Scheme currently provides around $500 per hearing aid for people who have permanent hearing loss and are not covered by the Hearing Aid Funding Scheme. This subsidy can be used once every six years if you are eligible.
Funding may also be available from ACC or Veterans’ Affairs NZ if you are eligible. Many audiologists also offer discounts to SuperGold card holders. If you have health insurance, you may also be able to get some of your hearing aid costs covered.
Hearing loss prevention
While hearing naturally declines as you get older, you can prevent major decline by looking after and protecting your ears. Avoiding excessively loud noises will help protect your ears from further damage. Noise from loud appliances, machinery, and firearms may damage your hearing after prolonged exposure. If you must be around loud noises, you should wear ear protection at all times.
While hearing aids help the majority of people with a mild to moderate hearing loss, for people with severe-to-profound hearing loss, hearing aids may offer little benefit.
Adults who are no longer deriving benefit from their hearing aids may benefit from cochlear implants. Unlike a hearing aid, which amplifies sound, a cochlear implant bypasses damaged hair cells in the cochlea and stimulates the
auditory nerve via electrical impulses.
How does a cochlear implant work?
A cochlear implant consists of an external processor and internal implant.
The external processor:
• A microphone picks up sounds from the environment;
• The speech processor (a computer) analyzes and digitizes the sound signals and sends them to a transmitter;
• The transmitter worn on the head sends the signal to the surgically implanted internal implant.
The internal implant:
The implant sits just under the skin behind the ear, receives signals from the processor and converts them into electric impulses. The electrode array placed within the cochlea receives the signal from the transmitter and stimulates the auditory nerve, which in turn, sends information to the brain to be interpreted as meaningful information.
In Aotearoa NZ there are 120 cochlear implants publicly funded for adults affected by a severe to profound hearing loss through the Northern and Southern Cochlear Implant Programmes. To find out more, visit here:
Ménière’s disease is a chronic inner ear disease that causes spells of vertigo (dizziness), hearing loss, and tinnitus. Ménière’s usually starts between young and middle-aged adulthood and cannot be cured. It is caused by the improper drainage of fluid in the ear, abnormal immune response, viral infection, or genetic predisposition. Some medications can be taken to improve symptoms, such as medicine for vertigo. You can also talk to your doctor or ear, nose, and throat specialist about other treatments or surgery.
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