Dear Doctors,
My wife’s insurance company is suggesting that she get a hearing test. She is only 51, and her hearing is fine. Does she really need to get this screening?
Dear Reader,
Although hearing loss is often associated with growing older, it can begin at any age. In some cases, it begins as early as the 30s and 40s, and it increases over time.
Hearing loss falls into a few major categories, which can occur in the outer, middle, or inner ear. Conductive hearing loss refers to sound being unable to move from the outer or middle ear into the inner ear, but it can often be repaired medically. Sensorineural hearing loss, on the other hand, refers to damage to the nerves involved in hearing and is irreversible. Some people may have a combination of both, which is known as mixed hearing loss. Age-related hearing loss is associated with physical changes to the hearing apparatus that occur as we grow older.
There are various other causes of hearing loss, including injury, high fever, diabetes, viral infections, stroke, certain medications, repeated exposure to loud noise, and heredity. Obstructions like wax buildup in the outer ear or fluid in the middle ear can also diminish hearing.
It is recommended that young adults have a hearing test when they reach their mid-20s as it provides a baseline for future tests. Once someone reaches their 50s, an annual hearing test is beneficial as part of preventive care. This can be arranged through a healthcare provider or an audiologist.
The most common form of hearing test, called a sound test, checks someone’s response to a range of sounds, tones, pitches, volumes, and spoken words. Another type of test, known as a tympanometry test, evaluates the movement of the eardrum to check for infections, wax or fluid buildup, and damage to the eardrum.
The initial signs of age-related hearing loss, affecting about one-third of older adults, can be subtle. Difficulty in understanding speech, especially in noisy environments, and the need for repetition are common. Soft and high-pitched voices become harder to hear, and words with certain sounds may seem muffled. Tinnitus, a ringing sound in the ears, may develop. Consistently turning up the volume on electronic devices can also be an indicator of hearing loss.
Decreased hearing can lead to isolation and difficulties in communication, information processing, and group activities. It has also been associated with an increased risk of cognitive decline. Even if your wife’s hearing is currently fine, it is still a good idea for her to have a hearing test to establish a baseline for the future.
(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)