Age-Related Audiology Conditions

Age-related audiology issues largely concern presbycusis (age-related hearing loss), which is the most prevalent sensory disability in older adults, affecting nearly a third of the world’s population aged over 65. The cumulative damage consists of hair cell loss in the basal turn of the cochlea, degeneration of cochlear nerve fibers, and atrophy of the stria vascularis, resulting in typical high-frequency loss over 3 kHz. This bilateral sensorineural hearing loss is caused by various factors.

Besides presbycusis, older individuals sometimes acquire central auditory processing disorder (CAPD), where diminishing brain processing in auditory pathways affects speech perception in loud surroundings despite preserved peripheral hearing. Tinnitus is more prevalent in older individuals and is associated with strial vascular atrophy and maladaptive central auditory compensation following peripheral hearing loss.

The implications go beyond the ears: ARHL independently promotes brain volume loss, especially in the temporal lobes, and the risk of dementia increases by 2–5-fold. Simultaneous peripheral audibility loss and central temporal processing deficiencies impair speech interpretation, particularly in noisy conversations.
Management includes hearing aids with frequency compression, auditory training for CAPD, tinnitus retraining therapy, and vestibular rehabilitation for concomitant balance problems.