Hearing loss in old age is caused by different factors – 03/17/2024 – Balance and Health

Approximately 157 million people, corresponding to 20.3% of the world’s population, suffered from hearing loss in 2019. And this prevalence is expected to increase as the population ages.

The first World Report on Hearing, released in 2021 by the WHO (World Health Organization), estimates that around 2.5 billion people will have some degree of hearing loss in 2050.

Hearing loss causes difficulties in verbal communication, which negatively affects several aspects of an individual’s life. Decreased cognitive function, loneliness, depression and high rates of unemployment are observed in patients.

The most common risk factor for hearing loss is aging. Known as presbycusis, it is characterized by a progressive, slow, persistent, bilateral and symmetric loss of high frequency. Hearing deterioration can begin in individuals in their 20s and 30s, although it usually occurs in people over 50.

Although age is a key precedent, new research, published in early March by the scientific journal PLoS One, reveals that men and women have different factors for presbycusis.

In the study, clinical information was collected, including age, sex, alcohol consumption and smoking status. For female participants, medical history was also investigated, such as age at menarche, childbirth history, age at menopause, and use of hormone replacement therapy.

Of the 2,349 participants, 1,104 were male (47%) and 1,245 were female (53%), with an average age of 60 to 94 years. As a result, it was confirmed that the prevalence of presbycusis is lower in women than in men, and that the age at which loss begins is later in females.

For the otorhinolaryngologist and member of the clinical staff at Hospital Israelita Albert Einstein, Mauricio Kurc, many more environmental factors come into play here than genetic ones.

This is because, historically, men tend to occupy positions with greater noise — musicians, drivers, pilots and construction workers are some of the professions affected by high decibels — in addition to men taking less care of health issues than women.

Ultimately, the research resulted in a discovery of specific associated factors for age-related hearing loss in men, which include being underweight and smoking. For women, obesity, low weight and late menarche can play an important role.

According to Jamal Azzam, specialist in Otorhinolaryngology at the HC (Hospital das Clínicas) of the Faculty of Medicine of USP (University of São Paulo), as the study itself mentions, it is not safe to make a direct relationship between the cause and effect of the factors in relation to hearing loss. .

“But the issues that must be monitored draw a lot of attention. Metabolic factors are directly involved, both in men and women”, he explains.

Causes of hearing loss in old age

Age-related hearing losses are human nature. This occurs due to a natural degeneration of cells in the cochlea, which is the place where mechanical sound waves are transformed into electrical waves that stimulate the auditory brain area.

However, several factors can worsen and accelerate the process, says Azzam, one of the main ones being excessive recreational noise, such as the use of headphones and clubs and parties with loud music.

In collecting data for the study, factors associated with hearing loss such as history of exposure to ototoxic drugs (those whose continuous use is capable of damaging ear structures, causing damage to auditory functions and also balance), family history of hearing loss and history of head trauma and infectious diseases were not assessed. However, experts say that these factors, especially genetics, are fundamental to associations with presbycusis.

Treatment and prevention

There is no treatment that cures hearing loss in the elderly. However, there are already several options to mitigate and compensate for hearing loss, such as the use of hearing aids and cochlear implants.

Faced with hearing loss, which is somewhat expected with age, prevention is the best medicine: the HC doctor suggests a visit to an otorhinolaryngologist once every two years, starting at the age of 50, and once per year from 60 onwards.

“Hearing loss can reduce brain stimuli, even being a cause of early dementia. It is important that the population is aware of all factors, as longevity is increasing and, if the person reaches old age already with worsening factors, The quality of hearing life will probably be lower”, explains Azzam.

---

Factors that help preserve hearing

• Avoid excessive and prolonged noise (both occupational and recreational);
• Balanced diet rich in vitamins;
• Detailed analysis of possible ototoxic medications;
• Annual hearing check-up from the age of 60;
• Immediate treatment from any symptoms.