The Silent March of Hearing Loss in Aging

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Q: I am concerned by a gradual change in my husband’s behavior. He does not socialize as much as he used to, and I feel guilty (and worried) as I tend to lose patience with him because he asks me to repeat myself all the time. His doctor did some memory tests and said it isn’t dementia, but did mention that he should get a hearing test. Could it be his hearing? My husband doesn’t seem to turn up the television too loud, but maybe there are other clues I’m missing.

A: I do think that a hearing impairment is a strong possibility, given your husband’s changes in behavior. This is often an early warning sign that all is not right with someone’s hearing. Unfortunately, hearing loss is an invisible disability as there are usually no physical warning signs, except in cases where people experience a constant ringing in the ears (tinnitus). Not only that, but since hearing loss is usually a gradual process that occurs over a 20- to 30-year period, people may not even realize what’s happening. And when they do, many are reluctant or embarrassed to do anything about being hard of hearing.

A Big Problem

Hearing loss is pervasive issue for older people. It is the third most common chronic medical condition in adults over 65, with only high blood pressure and arthritis affecting more people in this age group. In fact, age is the most significant factor involved with hearing loss. It’s estimated that over 40 percent of Americans 65 years and older have some degree of hearing impairment. That percentage goes up to 50 percent in adults over the age of 75 and to a staggering 80 percent in seniors over the age of 85. This is a serious concern because hearing impairment may present an increased safety risk. For instance, it may prevent them from hearing a smoke or carbon monoxide alarm, an automobile horn or other important warning sounds. Not only that, but a hearing impairment may further isolate people because they may not always hear the phone, doorbell or even alarm clock. Sad to say, but some seniors are thought to have a form of dementia because they have trouble following directions or remembering what was said in conversations, when in fact the real problem was that they couldn’t hear what was being said!

The Subtle Signs of Silence

If a person needs the volume turned up high on the television or radio, or if he is asking people to repeat themselves again and again, he most likely has already experienced a significant degree of hearing loss. The key is to catch the subtle clues early in order to prevent or postpone even more serious impairments, like depression, social isolation and accidents. To help determine if you or your loved one has a potential hearing problem, the American Academy of Audiology has developed a quick consumer hearing health test. Some of the questions to consider:

Do you find it difficult to follow a conversation in a noisy restaurant or crowded room?
Do you sometimes feel that people are mumbling or not speaking clearly?
Do you find yourself experiencing difficulty understanding soft or whispered speech?
Does a hearing problem cause you to feel embarrassed when meeting new people?
Do you sometimes have difficulty understanding speech on the telephone?
Do you experience ringing or noises in your ears?
Does a hearing problem cause you to visit friends, relatives or neighbors less often than you would like?
Do you feel handicapped by a hearing problem?
Have you had any significant noise exposure during work, recreation or military service?
Do you hear better with one ear than the other?

If the answer to any of the above is yes, make an appointment with an audiologist or an otolaryngologist, a physician specially trained in diagnosing and treating diseases of the inner ear.

Don’t Be Silent About Your Silence

A big mistake many seniors make is that they accept hearing loss as a normal part of getting older and don't mention it to their physician. This doesn’t have to be the case. If you are 65 years or above, please ask your doctor if you should get a baseline audiogram, or hearing test. If a hearing problem is detected, help could be close at hand. For instance, approximately 75 percent of the elderly who are hearing impaired may benefit from a hearing augmentation instrument, such as a hearing aid. And, for everyday safety and convenience, devices such as flashing doorbells and smoke alarms are available, as well as vibrating alarm clocks, captioned TV programs and amplification systems for the TV, radio and telephone.

As you have experienced, a hearing impairment not only affects the individual person but also his loved ones. Please get your husband’s hearing checked.

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Robert Danoff, D.O., M.S., is a family physician and program director of The Family Practice Residency, as well as the combined Family Practice/Emergency Medicine Residency programs at Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He is the medical correspondent for CN8, The Comcast Network, a regular contributor to Discovery Health Online and a contributing writer to The New York Times Special Features. (Read his full bio.)