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Hearing loss is a common problem among older individuals. Approximately
25% to 40% of adults older than 65 years have some degree of hearing loss, and
it is estimated that 40% to 66% of people aged 75 years and older have hearing
loss. Hearing loss is the third most common chronic health condition among
older Americans after high blood pressure and arthritis.
The April 16, 2003, issue of JAMA includes 2 articles on adult hearing loss.
Types of hearing loss
There are 2 major forms of hearing loss: conductive and
Conductive hearing loss is usually due to abnormalities
in the middle or external ear, such as a punctured eardrum, presence of fluid
in the middle ear, or accumulation of cerumen (ear wax) in the external ear
canal. These problems require evaluation by a doctor and can often be successfully
Sensorineural hearing loss is caused by damage
to the tiny hairs inside the cochlea that are crucial
for picking up sound vibrations and translating them into nerve impulses.
These impulses are relayed by the acoustic nerve
to the brain, which interprets them as sound. Sensorineural hearing loss accounts
for about 90% of hearing loss related to aging. Sensorineural hearing loss
usually occurs gradually in both ears. Patients with sensorineural hearing
loss often have a hard time filtering out background noises and tend to hear
lower-pitched sounds better than higher-pitched sounds. Sensorineural hearing
loss may be prevented by limiting exposure to loud noise. Ear protection (such
as ear plugs) should be worn to dampen sound if loud noise is unavoidable.
Treatment of sensorineural hearing loss may involve the use of sound
amplification devices like hearing aids. In cases of severe sensorineural
hearing loss, a surgical procedure called
cochlear implantation may be suggested. This procedure allows sound vibrations to bypass
the hair cells and directly stimulate the acoustic nerve to transport sound
signals to the brain.
Individuals with hearing loss should be evaluated by their primary care
physician, who may refer them to an otolaryngologist (a
doctor specializing in the ears, nose, and throat) or an audiologist
(an expert in hearing testing and hearing aids) for further evaluation and treatment.
For more information
American Academy of Otolaryngology-Head and Neck Surgeryhttp://www.entnet.org
American Speech-Language-Hearing Associationhttp://www.asha.org
American Academy of Audiologyhttp://www.audiology.org/consumer
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The information and recommendations appearing on this page are appropriate
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specific information concerning your personal medical condition, JAMA
suggests that you consult your physician. This page may be photocopied
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To purchase bulk reprints, call 718/946-7424.
Sources: National Institute on Deafness and Other Communication Disorders,
American Academy of Otolaryngology-Head and Neck Surgery, American Academy
of Audiology, American Speech-Language-Hearing Association
Parmet S, Lynm C, Glass RM. Adult Hearing Loss. JAMA. 2003;289(15):2020. doi:10.1001/jama.289.15.1895
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