By Jacqueline Simoneau
For most people, hearing diminishes with age, but you can take steps to delay the process
Although hearing loss affects people of all ages, the risks become much greater the older we get. “Over time, the hair cells in the cochlea, located in the inner ear, decline, leading to a progressive reduction in hearing in both ears,” says Dr. Owen Woods, an ear, nose, and throat specialist at Montreal’s Hôpital Maisonneuve-Rosemont. “This natural wear and tear, called presbycusis, is irreversible. The damaged cells will not regenerate. However, presbycusis happens differently from one person to another and can be managed.”
Hearing deterioration generally starts around age 40, but the first signs appear around age 50. The older a person, the higher the risk for hearing impairment. For example, at 65, one in three people will show some hearing loss; at 75, it’s one in two.
The Signs
Because a decrease in hearing happens gradually, it often takes time for people to become aware of the problem. In a study on hearing loss among Canadians aged 40 to 79, eight per cent of men and five per cent of women reported some hearing impairment. However, when researchers tested participants’ hearing, they found that 63 per cent of the men and 46 per cent of the women had measurable hearing loss.
“People who develop hearing loss tend to blame others for the problem, accusing them of mumbling or not enunciating,” says Chantal Laroche, an audiologist and professor emeritus in the Audiology/Speech-Language Pathology Program at the University of Ottawa. “Also, they compensate by making small changes, such as turning up the volume on the TV.”
Most often, it’s those around them who notice signs of a decrease in hearing, Woods says. When someone is having trouble following a conversation in a group or a noisy environment; if they have to move closer to understand the person they’re speaking to; if they make mistakes with words that sound similar; if they repeatedly ask others to speak up or to repeat what they’ve said; if they have trouble hearing high-frequency sounds such as a ringing phone; or if the people around them complain that the volume on the TV is too high or that they’re speaking too loudly— these are all clear indicators of hearing loss.
Other examples are if the person answers a question inappropriately or has tinnitus. Any of these signs should prompt a visit to a hearing specialist, as a decline in hearing isn’t a minor issue.
“Reduced hearing can be at the heart of communication problems, mis- understandings, and misinterpretations, which can damage personal, social, and professional relationships,” Laroche says. “The more severe the problem, the more people tend to become socially isolated, which can lead to depression.” Moreover, many studies show that untreated hearing loss can accelerate cognitive decline through a lack of stimulation.
The Volume
The primary cause of presbycusis is aging, at times linked to genetic factors, and that’s something over which you have no control. However, some things over which you do have control—such as medications, some diseases, and especially noise—can accelerate the process.
“In addition to aging, regular exposure to loud noises is a main factor in hearing loss,” Laroche says. Headphones and earbuds in particular can create problems. They’re ubiquitous these days—for listening to music, a podcast, or the radio.
Can using headphones for decades and still using them today accelerate age-related hearing loss? Not necessarily, Woods says: “Wearing headphones isn’t a problem in itself. It depends on the volume, how long you listen for, and how often you use them.
There’s no cause for alarm if you use them for a few hours a day at a suitable sound level. But if you’re wearing them for more hours at high volume, you can definitely damage the hair cells in the inner ear and develop hearing loss or hasten presbycusis. The higher the volume and the longer headphones are used, the higher the risk.”
Wearing headphones isn’t the only cause of damage linked to noise, however. The noisy environment in which we live—with its traffic, construction, and crowded restaurants—is just as bad. Last May, a Léger survey on hearing health found that 48 per cent of respondents said they weren’t well informed of the risks associated with noisy recreational activities (such as concerts, bars, movies, and headphone use), and 65 per cent said they felt discomfort such as tinnitus, blocked ears, pain, and hypersensitive hearing after a noisy activity without adequate hearing protection.
At first, hearing loss related to recreational activities is often temporary, but be careful: the damage is cumulative. Over time, these effects will add to hearing loss due to aging. As a result, repeated or prolonged exposure to loud sounds can cause irreversible lesions and permanent deafness.
Effective Steps to Take
How do you know if a sound is too loud? According to Laroche, the maximum limit for hearing safety with headphones is 70 decibels (dB), which corresponds more or less to the sound made by the average washing machine. The World Health Organization recommends the 60/60 rule: that is, 60 per cent of maximum volume for no more than 60 minutes at a time.
It’s also recommended that you use noise-cancelling headphones that allow you to hear sounds without having to increase the volume to an excessive level in a noisy environment. Headsets are preferable to earbud-style headphones, as they’re more easily adjusted, which means better noise mitigation.
Laroche points out, however, that you shouldn’t wear headphones when you’re on the move outdoors: “By eliminating background noise, you put yourself in danger.” Furthermore, it’s recommended that you take regular breaks to prevent auditory fatigue, ideally 10 minutes per hour of listening.
During a concert, it’s important to wear appropriate hearing protection and to stay a good distance from speakers. Protection is also encouraged when you’re using a noisy piece of equipment, such as an electric saw, a lawnmower, or a leaf blower. Finally, avoid sleeping while listening with a headset or headphones. Wear earplugs to sleep if your surroundings are noisy.
Another way to protect your hearing and delay hearing loss is to prevent or manage diseases such as diabetes, high blood pressure, and hypothyroidism, which predispose someone to impaired hearing.
Hearing loss is not a trivial thing. Thankfully, solutions exist to preserve it for as long as possible.
A (Too)-Well-Kept Secret
“Hearing loss is still a taboo subject,” says Dr. Owen Woods, an ear, nose, and throat specialist at Montreal’s Hôpital Maisonneuve-Rosemont. “Many people associate it with aging. And those who have it are reluctant to talk about it for fear of how other people will look at them or of being judged.”
This could explain why people wait an average of seven years before seeing a professional, according to Quebec’s order of speech-language pathologists and audiologists. Even more surprising, only 20 per cent of adults with hearing loss use hearing aids.
Yet the benefits of hearing aids shouldn’t be underestimated— they can greatly improve a person’s quality of life. Plus, the new generation of hearing aids can’t be compared with older models. The new ones are smaller, discreet, and accurate. They also offer good audio quality and many functions adapted to each person’s needs.
Do you think your hearing has diminished? See a hearing-health professional for a hearing screening test. Some clinics offer these at no cost. All you need to do is make an appointment.
