The term “presbycusis” refers to hearing loss that is associated with the cochlear degenerative process of aging. By definition, presbycusis is bilateral, symmetrical, and slowly progressive.1
Hearing loss is a common problem associated with senescence, and it is likely to become more of an issue with changing population demographics in the developed world. The impact of hearing loss may be profound, with consequences for the social, functional, and psychological well-being of the person.
On one side, our lack of understanding of this disease process and our inability to remediate its progression are important parts of the problem. At present, clinicians can only use family history, the history of onset and progression, and the results of audiometric testing to determine the degree of impairment, to estimate the potential for future hearing loss, and to make recommendations for amplification with hearing aids.
On the other side, optimal management of this condition also should include an evaluation of quality of life (QoL) status and its assessment. This is due to the fact that several studies have already demonstrated that presbycusis may have a negative effect on QoL and psychological well-being – social isolation, depression, anxiety, and even cognitive decline have been reported in affected persons.1
Despite efforts to understand the disease processes, at present, clinicians are still unable to remediate its progression.
Epidemiology and risk factors of presbycusis: a challenging problem
Presbycusis is the most common cause of adult hearing deficiency; it is considered the most prevalent sensory impairment in the elderly, affecting individuals aged 75 years and older. As our society matures, there are more people living into their 60s, 70s, 80s, and beyond, due to factors such as improved nutrition and health care. It has been reported that, in the United States, presbycusis affects 40% of the population older than 75 years of age, and, in our aging society, it is becoming more prevalent.1
The 1995 UK national study of hearing disorders found that 20% of adults had some degree of hearing impairment (audiometric threshold greater than 25 dB) in the better hearing ear; 75% of those are over 60 years of age.1
Recent estimations suggest that the number of senior citizens in the US with significant hearing loss could increase to 35–40 million by the year 2030.1
Aging is defined as the biological process of growing old, and intrinsic and extrinsic factors, as well as their interactions, influence the degree and rate at which our hearing ages. Thus, the occurrence of presbycusis is thought to be determined predominantly by genetic factors; however, it also can be influenced by environmental factors, such as noise, ototoxic drugs, alcohol, and diabetes.4