The other day, after going over a patient’s audiogram, she paused and asked me the most common question I hear at my audiology clinic in Lawrenceville, New Jersey: “but is this normal for my age?”
I’ve had many patients come in and ask me if their hearing loss was “normal” for their age. I hear this question a lot, actually. Many assume that they have a hearing loss simply associated with advanced age. This is not always and necessarily true.
Roughly one in three people in the United States between the ages 65 and 74 have hearing loss, nearly half of those older than 75 have difficulty hearing. Presbycusis, or hearing loss associated with aging, does indeed affect older adults. It is not the only factor, however. Noise exposure, cardiovascular disease, infections, genetics or birth defects, ototoxic drugs, diabetes, and/or heavy tobacco use can exacerbate or cause an earlier onset of hearing loss than aging alone.
Hearing loss at an older age is the sum of all that has happened to your ears over the course of your life. Factors such as noise exposure, ototoxic medication, genetics, medical conditions (such as high blood pressure and diabetes) all contribute to the loss of hearing.
Have you been exposed to loud noises for extended periods of time, like rock concerts or construction? Are you involved in recreational sports such as shooting ranges and hunting? Have you protected your ears when involved in these activities?
If you are on medication for high blood pressure or chemotherapeutic agents, you may be experiencing hearing loss (and tinnitus) related to these medications’ side effects. Are you diabetic? If so, consider your ear as an end organ equally affected by the disruption of blood supply to important blood vessels and nerves.
Your audiologist will ask questions about your medical, work and recreational history to get an idea of what your ears have been through. It is not age that has caused your hearing loss, it is all of the contributions of what has happened to your ears throughout your life.
Yes, hearing loss is more common as we age, but its effects are never “normal.” Hearing loss causes mental fatigue, social withdrawal and isolation, frustration, anxiety, depression, affects performance at work, affects our relationships, AND contributes to the risk of dementia due to cognitive overload (the brain is simply working too hard to hear and process auditory information). How can we call all this “normal”?
The more important question to ask, however, is “how has your hearing loss affected your life?” Are you able to hold a conversation with your wife or husband at home with ease? What are family dinners like for you? Can you stay on topic and respond appropriately? Do you nod your head in agreement when someone has cracked a joke at the table, pretending to hear it? What is it like when you go out for dinner with friends? Have hearing issues led you to withdraw from social engagements with friends or family?
If you have found yourself withdrawing from socializing, work, or family, your hearing loss is affecting your life. It is impacting your ability to engage in life the way you desire. This is not “normal” regardless of your age. You shouldn’t be constantly guessing at what others are saying at a dinner table, or asking your wife or husband to frequently repeat what they are saying. It is not normal to decline a dinner invitation because you “probably won’t hear what everyone is saying anyway.” None of this is normal.
Just as we schedule annual dental, vision and physical appointments, we need to schedule audiologist appointments to check our hearing. Good communication lies at the heart of all relationships. Taking care of our ears means our relationships are important to us. We want to continue to stay engaged with our friends, co-workers, and family. We want to be able to express who we are and hear what others have to say. Normal means you are living fully as the person you are, were, or meant to be, no matter what age you are.
Get your hearing checked by an audiologist who uses Best Practices. Your audiologist may then recommend a hearing aid, cochlear implants, assistive listening devices, and/or apps on your phone in conjunction with an aural rehabilitation plan to help you hear better. Know that it is a journey, but one that will get you back out there to be your normal self.