Did you know that around 10% of New Zealanders suffer from some form of hearing loss?
And that men are more likely to suffer from hearing loss? If not you may be interested to know that:
- Over 90,000 more New Zealand men than women report hearing loss. The difference is similar to that for other developed countries and is attributed to exposure to occupational noise.
- People over the age of 65 years are three times more likely to have hearing loss than younger adults. (In both Australia and New Zealand 50 - 60% of the adult population over the age of 60 years have some degree of hearing impairment).
- Hearing loss is preceded only by dementia as one of the top ten leading causes of years lost due to disability among older Australians and New Zealanders.
- Hearing loss is linked to withdrawal from social and vocational activities, and has been shown to significantly affect relationships with family and friends.
- People with acquired hearing loss show anxiety and depressive symptoms at four to five times the rate exhibited by people with normal hearing.
- Four out of five people who need a hearing aid, don't wear one.
- A survey of hearing aid users indicates that hearing aids have helped improve family relationships and their self-esteem.
- Early intervention in aged-related hearing loss affords the best chance for successful aural rehabilitation, promotes healthy communication and may reduce the effects of other serious health issues for older people.
Possible Aetiology of hearing loss in the older generation
Peripheral impairment
Cochlear damage may result from a number of things. Presbycusis, excessive noise exposure, diseases such as Meniere's disease, otosclerosis, viruses, ototoxic drugs, head injuries, and perforations due to disease or trauma. Damage to hair cells in the cochlea prevents sound being transmitted along the auditory pathway, sometimes causing permanent irreversible deterioration in the auditory cortex.
Noise induced hearing loss
Excessive noise exposure either in the work place or through recreation will cause damage to the hair cells within the inner ear. For many older people the noise will have occurred while in the work place or when they were in the armed services. If there is a suspicion of noise induced hearing loss arising from work, referral to ACC is recommended. If the person served in the armed services, Veterans affairs may be able to offer some assistance. It is important to remember that many women have worked in noise so are eligible for assistance through ACC or veterans affairs.
Presbycusis
Presbycusis is the global term for the handicapping effects of hearing loss associated with aging. Presbycusis may involve:
- Peripheral reduction in hearing threshold sensitivity which raises hearing thresholds and also may distort sounds, and; impairment of the central auditory processing system which impacts on the rapid processing of speech and the ability to recognise speech in noise or reverberation.
Auditory deprivation
Auditory deprivation refers to the process that occurs when an ear receives reduced or no auditory stimulation over a long period. When there is a reduced auditory stimulation, the auditory cortex's ability to process auditory stimuli may be reduced.
If a person exhibits a moderate hearing loss or more in both ears, and chooses to wear a hearing aid in only one ear, research suggests that the aided ear may become strongly dominant for intelligibility while the unaided ear may deteriorate.
Central impairment
A minority of older people with hearing impairment experience more difficulty understanding speech than one would predict from the degree of loss of their peripheral hearing. This may indicate a problem related to the central processing of auditory information and degeneration of neural pathways in the auditory system rather than central plasticity secondary to peripheral hearing loss.
What can be done to help?
Hearing aids
Nowadays there are many options available. For people with arthritis or visual problems, aids can be made automatic, or rechargeable. The level of technology is chosen based on the environments that they are in. Aids range anywhere from a basic model designed to only work well in quiet up to an advanced aid designed to function in more challenging situations.
Assistive listening devices
Some people only have difficulty in certain situations (e.g. on the phone or when watching TV). For these people we will often look at assistive devices designed to help with their specific needs (e.g. amplified phone, infra-red system for the TV).
Listening skills
Most hearing impaired people benefit from knowing how to position themselves in a room, how to ask the appropriate questions to get the required information. With technology advancing as it is, it is also important that clients have appropriate expectations of what an aid can do. After all, even some one with normal hearing struggles in some environments.
If you are concerned about your patients hearing, please refer them to Dilworth Hearing, your local hearing care professionals.
