CHAPTER ONE
Aging and Hearing Loss
James F. Maurer, Ph.D.

This chapter remains dedicated to those of you who are 50 years and older. It is also written for your friends and relatives who wish to understand the causes and consequences of hearing problems as they relate to aging. In reading these pages you will discover strategies for helping the person with hearing difficulties.

     More than 34 million Americans are affected by hearing loss and fully two-thirds are over the age of 55. Among the chronic health conditions of the 65 and older group, hearing impairment ranks near the top. Also, almost half of this population has at least two chronic health conditions, and this trend appears on the increase. Over age seventy the incidence of hearing disabilities increases to nearly 50 percent. Unfortunately, loss of hearing is more prevalent than ever in history, yet the gradual course of auditory aging is not the primary cause of this problem. What has changed since the 1960s is the increasing acceptance of noise—a topic we will re-visit.

     Hearing instruments have continued advance technologically. The most revolutionary advancement is probably the “Open Fit” (also called open ear or open canal) hearing instruments, which are largely invisible to the observer and can be fitted to people with mild through moderately severe hearing losses. But this new design is especially friendly to seniors with characteristic audiograms that fall off in the high frequencies and physical handling difficulties experienced with some other types of hearing instruments.

     Many older persons listen to music, although a hearing difficulty may interfere with their enjoyment. Since a typical hearing loss during the aging years robs them of higher pitch sounds that are audible to normal hearing people, the hearing-impaired tend to increase the volume in order to make the music more audible, sometimes to the discomfort of others. A problem with this adjustment is that when the music is made louder, lower pitch notes become amplified as well, and may register as being too loud for some listeners like the guy beating on the wall. Emphasizing just the high notes can be helped somewhat by changing the tone control to high tone emphasis, if such an adjustment is available on the television set, radio or stereo system. Of course the hearing sense is much finer tuned than the tone control circuit in a stereo. The enhancement of higher frequency notes is better accomplished with a properly fitted and appropriately tuned digital hearing instrument.

     Another factor that interferes with listening enjoyment is a phenomenon called “recruitment.” Recruitment is the abnormal growth of loudness that may occur among some persons with sensory hearing losses. These individuals react aversively to loud sounds, such as shouting, banging on metal, sharp high pitch sounds and even loud music. They require special care in the selection of appropriate hearing aid characteristics.

     It’s important to know that when you take charge of any sensory limitation with proper eyeglasses, hearing instruments, etc., you’re really taking care of your brain, the single most important organ in your body. When your ears transmit sounds to the brain as electrical impulses, it is the brain that actually hears. And when your hearing aid helps you hear high frequency sounds in music or in speech, these “new” sounds reach the brain and it immediately “plasticizes” the experience.

     In its healthy state the brain is plastic, busying itself with establishing neural networks that represent your new activities. Ageing behaviors, such as continually seeking comfort, being reluctant to try new activities, ignoring the changes going on around you, and adhering to the “old ways” of doing things fail to release the neurotransmitters that signal plasticity. You’ve given up and so has your brain. You’re on a downhill slope with no skis. In other words, your aging behaviors foster more aging.