Clinical investigation of hearing loss in the elderly

The prevalence of hearing loss increases with age. Epidemiological and histopathological studies relating hearing loss to age are reviewed and clinical evidence presented suggesting that hearing loss is due not only to age but also to disease processes known to be associated with hearing threshold deterioration. 80 elderly patients presenting with a hearing problem at hospital have been studied and compared with 287 'non-complainers'. 83% of the study group were found to have factors, additional to age, contributing to their hearing loss; 50% had a medical condition previously unrecognized; 30% were taking potentially ototoxic drugs. Audiometric measurements indicate that hearing thresholds of the elderly are influenced by numerous disease processes. Patients attending hospital with hearing impairment are at greater risk of having a vascular or biochemical abnormality than a group of elderly 'non-complainers'. Elderly patients presenting with hearing loss should therefore be adequately investigated before being labelled as having presbyacusis.