Concept

Presbycusis

Summary
Presbycusis (also spelled presbyacusis, from Greek πρέσβυς presbys "old" + ἄκουσις akousis "hearing"), or age-related hearing loss, is the cumulative effect of aging on hearing. It is a progressive and irreversible bilateral symmetrical age-related sensorineural hearing loss resulting from degeneration of the cochlea or associated structures of the inner ear or auditory nerves. The hearing loss is most marked at higher frequencies. Hearing loss that accumulates with age but is caused by factors other than normal aging (nosocusis and sociocusis) is not presbycusis, although differentiating the individual effects of distinct causes of hearing loss can be difficult. The cause of presbycusis is a combination of genetics, cumulative environmental exposures and pathophysiological changes related to aging. At present there are no preventive measures known; treatment is by hearing aid or surgical implant. Presbycusis is the most common cause of hearing loss, affecting one out of three persons by age 65, and one out of two by age 75. Presbycusis is the second most common illness next to arthritis in aged people. Many vertebrates such as fish, birds and amphibians do not experience presbycusis in old age as they are able to regenerate their cochlear sensory cells, whereas mammals including humans have genetically lost this regenerative ability. Primary symptoms: sounds or speech becoming dull, muffled or attenuated need for increased volume on television, radio, music and other audio sources difficulty using the telephone loss of directionality of sound difficulty understanding speech, especially women and children difficulty in speech discrimination against background noise (cocktail party effect) Secondary symptoms: hyperacusis, heightened sensitivity to certain volumes and frequencies of sound, resulting from "recruitment" tinnitus, ringing, buzzing, hissing or other sounds in the ear when no external sound is present Usually occurs after age 50, but deterioration in hearing has been found to start very early, from about the age of 18 years.
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