From the Guidelines
Asymptomatic gradual hearing loss in the elderly is primarily caused by age-related changes to the inner ear, a condition known as presbycusis, as well as other factors such as long-term noise exposure, certain medical conditions, and genetic predisposition. This natural aging process damages the sensory hair cells in the cochlea and affects the auditory nerve pathways, leading to progressive hearing deterioration 1. Other significant causes include long-term noise exposure throughout life, which compounds the natural aging effects, and certain medical conditions like diabetes, hypertension, and atherosclerosis that reduce blood flow to the inner ear. Medications can also contribute to hearing loss, particularly ototoxic medications, which are an independent risk factor for hearing loss 1. Genetic factors play a role as well, with family history increasing susceptibility, and approximately half of the variance in age-related hearing loss (ARHL) may be heritable 1.
The gradual nature of this hearing loss often means it goes unnoticed until significant communication difficulties arise. Regular hearing assessments after age 60 are recommended, as early intervention with hearing aids or assistive devices can significantly improve quality of life and help prevent social isolation and cognitive decline that often accompany untreated hearing loss. In fact, research has shown that hearing loss is associated with an increased risk of dementia, frailty, and falls, as well as decreased social engagement and quality of life 1.
Some key points to consider include:
- Age is a significant risk factor for the development of hearing loss, with approximately 65.3% of adults 71 years and older having at least some degree of hearing loss 1
- Chronic medical conditions, such as hypertension, diabetes, and hypercholesterolemia, may influence the development of hearing loss 1
- Population-level research has identified sociodemographic factors linked to ARHL, including a higher prevalence of ARHL in males compared with females 1
- Hearing loss tends to be associated with major depression that develops in late life, as well as social isolation and decreased quality of life 1
From the Research
Causes of Asymptomatic Gradual Hearing Loss in the Elderly
- Asymptomatic gradual hearing loss in the elderly can be caused by various factors, including diabetes mellitus 2.
- Individuals with diabetes have twice the incidence of hearing loss compared to those without diabetes, and those with prediabetes have a 30% higher rate of hearing loss 2.
- The relationship between diabetes and sensorineural hearing loss is complex, and hearing loss has its own set of risk factors that share others with diabetes 2.
- Glycemic control status, measured by glycated hemoglobin (HbA1c) level, is significantly associated with elevated hearing thresholds in type 2 diabetic patients 3.
- Poor glycemic control status, defined as HbA1c ≥ 7%, is linked to higher hearing thresholds, particularly at higher frequencies 3.
- The duration of diabetes and fasting blood sugar level do not appear to have a statistically significant impact on hearing thresholds, except at 16 000 Hz 3.