Deafness in Elderly - Causes, Symptoms and Treatment

The famous deafness of the elderly is caused by the natural hearing loss that occurs with aging; this change is called in presbycusis medicine. Presbycusis is a multifactorial disease characterized by progressive loss of hearing in both ears throughout life. This hearing impairment usually affects the high frequencies of the hearing.

Deafness and hearing aid
Deafness and hearing aid

Hearing loss has a huge impact on the quality of life of millions of elderly individuals, and is becoming an increasingly common disorder with the aging population.


Hearing loss becomes more common as the individual ages. About 11% of patients between the ages of 44 and 54 already have some hearing loss. This percentage rises to 25% among people aged 55 and 65 and reaches almost 50% of the population over 70 years.

It is believed that heredity and chronic exposure to loud noises are the main factors that contribute to hearing loss over time.

Other factors can also accelerate hearing loss over a lifetime, including:

1. Use of toxic substances in the ears, such as:
  • Antibiotics of the aminoglycoside class at high doses.
  • Chemotherapy
  • Chronic use of aspirin
  • Chronic use of anti-inflammatories
  • Sildenafil (Viagra)
  • Cocaine
  • Chloroquine
  • Intoxication by heavy metals such as mercury, lead or arsenic

2. Infections:

3. Smoking.
4. Hypertension.
5. Diabetes.
6. Trauma.


The main characteristic of presbycusis is the progressive and symmetrical loss of high frequency hearing over the years. This hearing loss can also be accompanied by tinnitus, vertigo and imbalance.

The human being is able to hear frequencies between 20 Hz and 20000 Hz (20 KHz). Many adults are no longer able to hear frequencies above 15000 Hz (15 KHz). In presbycusis, hearing loss is even greater and the frequencies most affected are those above 2000 Hz (2 KHz).

Over the years, the ability to hear high frequencies continues to fall, and medium and low frequencies (0.5 to 2 KHz), associated with human speech, also become progressively involved.

On average, we use sounds with frequencies ranging from 250 Hz to 4000 Hz (4 kHz). In human speech the vowels are usually of medium and low frequency while the consonants are of high frequency. Some consonants with the "Z" sound, for example, can have frequencies up to 8000 Hz (8 KHz). As a result, patients with high-frequency hearing loss often report being able to hear when someone is speaking, but not understanding what is being said due to the loss of information on consonant sounds.

Auditive difficulty is exacerbated in the presence of background noise. Patients who are hearing impaired by age tend to perform reasonably well in private conversations in a quiet room, but experience difficulties in social settings. Patients also complain of having more difficulty hearing women than men, since they naturally have a higher frequency speech (do not confuse the frequency of sound with the height of the speech).

A common finding in patients with hearing loss is a paradoxical hypersensitivity to loud sounds. Older people may complain that sounds become too loud when they are actually at levels that are easily tolerated by people with normal hearing. This change explains why screaming with patients with presbycusis can often be quite counterproductive. People think they need to talk too loud so that elderly people with some degree of deafness can hear them. When we shout, the low-frequency vowels are amplified, while the consonants remain inaudible, which can be very uncomfortable for the listener. In presbycusis the problem is much more in relation to the frequencies of the sound than to the intensity of the same. Shouting only works if the patient has other causes for hearing loss,

The vast majority of patients take several years to seek medical help for their hearing loss. This is due in part to the insidious onset of the disease as well as the negative stigma associated with hearing aid use.

The majority of the elderly see some degree of hearing loss as inevitable and untreatable. However, presbycusis when unrecognized and treated can lead to progressive social isolation and depression, especially if the patient also has other functional limitations, such as difficulty walking or visual deficits.

Tinnitus can also be a major problem in presbycusis. The sound is usually described as a buzzing affecting both ears or diffusely "inside the head".

Anyone who feels some degree of hearing loss should seek an otolaryngologist. This doctor is able to diagnose hearing loss and to identify your cause (s). With an exam called audiogram, the doctor is able to identify hearing loss. During this test, with headphones, you will hear sounds directed to one ear at a time. The otorhinolaryngologist will present a range of sounds, frequencies and also several words to determine your hearing ability.


There is no treatment that prevents or cures hearing loss in the elderly. However, there are several options for attenuating and compensating for hearing loss.

Hearing aids

Hearing aids can improve auditory function in most cases of presbycusis. Hearing loss rarely becomes so severe that hearing aids are not effective in restoring the ability to communicate.

The technological advances of hearing aids in recent years have significantly improved their performance, minimizing the bad experiences that were once common. However, since there are several models on the market, you may have to try out a few options before you find the hearing aid that best suits you.

Hearing aids also help to improve the tinnitus experienced by many patients with presbycusis.

Cochlear implant

For patients with severe hearing loss in whom the hearing aid is not effective, there is the option of a cochlear implant. The cochlear implant involves placing a set of electrodes inside the inner ear to directly stimulate the neurons responsible for the interpretation of sounds. This procedure can be performed safely even in people over 80 years of age.

Cochlear implants are indicated for people with severe bilateral hearing loss who do not improve significantly with hearing aids.

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