More and more studies are showing that older adults who have a loss of hearing are at increased risk of developing dementia, and/or Alzheimer disease. Studies also show that the risk for developing dementia increases significantly as hearing loss becomes worse. Several studies have been conducted with the express intention of exploring potential solutions for the soaring incidence of dementia, with estimates now predicting that more than 100 million people will be affected globally, when the year 2050 is reached.
Researchers claim that any kind of interventions which would have the effect of deferring the onset of dementia by as little as a single year, could lead to at least a 10% decrease in the widespread occurrence of the disease over the next four decades. The problem with that is that a great deal more research is necessary before those potential interventions can be identified, since at present, there is very little evidence that interventions can be beneficial in this area.
The reason that the concept of interventions is so appealing to medical personnel is because of the universal understanding that dementia would be far easier to prevent than it is to cure or reverse. It is known that people are more likely to develop dementia when they have relatively little participation in leisure activities or any kind of social interactions.
Other risk factors for developing dementia occur in people who are relatively sedentary, or those who develop diabetes mellitus. It’s also known that one of the most prevalent reasons for elderly people not participating in social events and activities is that they have experienced some level of hearing loss, and are reluctant to become involved, because of the potential for embarrassment.
Testing for Hearing Loss
Given the fact that hearing loss is one of the precursors to social disengagement, and that social disengagement is a precursor to dementia, researchers have considered it very important to explore the causes of hearing loss. A landmark study conducted by Dr. Frank R Lin of Johns Hopkins Medical Institution has examined the effects of hearing loss on almost 700 people aged between 36 and 90, none of whom had dementia when the study began.
Participants were all required to undergo cognitive and hearing tests for approximately five years beginning in 1990, and were re-tested in the year 2008 for the possibility of having developed dementia or Alzheimer’s. Of all the participants in the program, almost 200 had some level of hearing loss when the study began.
When participants were re-tested more than a decade later, 58 of them had full-blown dementia, including 37 who had Alzheimer’s disease. The precise statistics taken during the study indicated that the risk for dementia increased significantly for participants who had at least a 25 dB hearing loss, and the dementia risk escalated right along with the level of hearing loss. In effect, those participants who had the worst level of hearing loss were also those most likely to be diagnosed with dementia.
Particularly for the study participants who were older than 60, there was a 37% risk of developing dementia which was linked to hearing loss. A strong correlation was found between the level of hearing loss and the likelihood of diagnosing dementia in these older citizens, and it was found that for every 10 dB more of hearing loss, the increased risk of developing dementia went up by 20%.
The Link between Dementia and Hearing Loss
The clear association between hearing loss and dementia found in this study and others conducted afterward, show that there is at least a possibility there is a common cause which underlies both conditions. Some scientists and medical personnel theorize that the link between the two stems from the fact that the more profound hearing loss is in an individual, the more likely that individual is to avoid social interaction.
When social interaction is avoided to a significant degree, and borders on isolation, the risk factors for developing dementia rise dramatically. This has led scientists to consider the possibility of experimenting with an intervention to improve the hearing of senior citizens at the earliest stage possible, so that no further damage occurs to hearing, and so hearing loss does not worsen.
There will undoubtedly be studies in the near future which explore the connection between a hearing loss intervention and the possible reduced risk of developing dementia. It’s entirely possible that by early detection of hearing problems in seniors, and taking aggressive corrective measures, the risk of developing dementia can be significantly reduced.
This is a tantalizing proposition, because hearing loss in most cases is a very preventable condition, and it can be effectively addressed using modern technology such as hearing aids or cochlear implants. Rehabilitative interventions might also be implemented which would create social environments that are optimal for better hearing, so that seniors would have few reservations about participating.
If this theory is found to have relevance and accuracy, it may represent one of the very best ways of intervening to reduce the runaway development of dementia in the elderly. At present however, this must remain in the realm of conjecture and theory, and it will be necessary for scientific study and research to establish the accuracy of the theory.
Hearing loss is the third most common health problem in this country, behind only arthritis and heart disease, so it’s apparent that a great many people are finding it difficult to maintain good hearing health by the time they reach their later years. It is especially important that good hearing health be observed because a number of studies have discovered a strong link between reduced hearing capability and dementia.
Once people in their later years have experienced a significant level of hearing loss, they tend to become less social and less engaged with others, and this is one of the primary triggers for the development of dementia. That being the case, it just makes good sense for every American to do whatever is possible to maintain good hearing health, both for the present and for senior years.
While nothing you can do will really guarantee that your hearing remains extremely good as a senior, there are some things you can do which will increase your chances of maintaining good hearing throughout your life. Below are described a few simple things that everyone can do to have a better chance of retaining optimal hearing, now in the future.
Avoid Loud Noises
It’s important to have an understanding of the sound level of your environment, as well as any special environments you walk into. Some of these scenarios include rock concerts, construction sites, and loud noises from city traffic. When you are exposed to situations like these, it’s a good idea to wear ear protection such as foam plugs, which will reduce the level of noise which reaches the middle ear. Keep in mind that anytime your ears are exposed to a situation where extremely loud noises are present, it takes at least 16 hours of quiet in order for the ears to recover from the sensory experience.
By placing either a rubber plug or a foam plug in your outer ear, the level of noise can be reduced by as much as 30 dB, thereby sparing the middle ear from significant damage. If you work in a setting which has a consistent level of relatively loud noise, it would be a good idea to take periodic breaks, so that your ears have recovery time.
Most people enjoy listening to music on their phones, and to personalize the experience, headphones or earbuds are generally used. If you are in this category, you should make a point of keeping the volume on your device to either low or midrange, especially if you’re going to have the earbuds in place for a prolonged period of time.
If you set the volume on high, you run a risk of causing damage to your ears, especially if this is something you do daily, and for several hours each day.
Adopt a Healthy Lifestyle
A number of studies have linked heart health with hearing health, and it has even been said that the ear is the window to the heart. Being physically active is a great way to maintain heart health, and to keep the heart muscle strong, so as to avoid the many different kinds of disease and other issues which can impact the heart.
A regular program of exercise that benefits the heart will also indirectly benefit your ears, so making exercise a priority is a good idea. However, before you embark on any strenuous program of exercise, make sure to consult with your doctor, so that you can be sure of activities which are appropriate to your age and to your health status.
One other factor related to maintaining a healthy lifestyle is that you should quit cigarette smoking, and if you haven’t yet started, make sure that you don’t. Researchers have found that cigarette smoking may have a direct bearing on hearing because it affects antioxidative mechanisms as well as the vasculature which supplies the entire auditory system.
Good Ear Care
Avoid physical damage as much as possible by resisting the temptation to put things into your ears, even seemingly harmless objects like Q-tips. If your ear canal becomes scratched somehow, your hearing is likely to be degraded. Sharp objects should never be put into the ears, because these can cause scratches, and can even puncture the eardrum, in addition to causing hearing loss.
You should make a point of removing earwax regularly because any kind of buildup will cause the sound to be muffled. However, care must be used in removing earwax, because cotton swabs may have the undesirable effect of pushing the earwax further into the ear canal, and that may necessitate professional expertise in removing it.
Have your hearing checked periodically so that you are aware of any incremental hearing loss since your last checkup. As a general rule, less than 15% of Americans actually have their hearing checked during their annual physical exam – and yet as mentioned above, hearing loss is the third most common health complaint in the country.
There are certain medications which can cause damage to the ear, especially those medicines taken by older adults routinely. Prescription medications should all be checked by your doctor to make sure they won’t have any impact on your hearing health.
Whenever you suspect that you are observing a sign of hearing loss, it should be reported to your doctor for further examination. Some of these warning signals might include speech which sounds muffled, difficulty interpreting conversation, or frequently requesting others to talk louder.
Sometimes you may have difficulty hearing certain consonants, and this may prompt you to avoid conversations. Be aware that such behaviors can be warning signs of hearing loss, and any sign of reduced hearing health should be checked out at an early stage, so it doesn’t have a chance to become significantly worse.
Acoustic neuromas are benign tumors that develop very slowly, on the eighth cranial nerve inside the ear, and they can have a major impact on a person. It is known that only about five individuals out of 100,000 actually have acoustic neuromas, but those who do have them may experience symptoms such as facial numbness, vertigo, a slow diminution of hearing in one or the other ear, problems with balance, and possibly tinnitus.
In extreme cases, the tumor itself can grow to a size where it actually becomes life-threatening, so its early detection is very important. The issue with early detection is that, as mentioned, the development of such a tumor is generally slow, which makes the symptoms experienced very gradual in nature.
In many cases, these symptoms are actually just attributed to normal aging and don’t attract any real attention because they’re thought to be a consequence of diminishing capability. Individuals who experience any of the symptoms referenced above should seek medical attention at the earliest opportunity. This is so that if there is an acoustic neuroma in progress, steps can be taken to have it treated before it gets critical.
How Acoustic Neuromas Develop
The cranial nerve where a neuroma begins to develop is the nerve which joins the inner ear and the brain, and it has a profound impact on both hearing and balance. This is why the symptoms of an acoustic neuroma include side effects that are both hearing-related and balance-related. It’s common for people with an acoustic neuroma to have problems with steadiness in their daily routine, even walking around the household.
Hearing can be impacted by the development of tinnitus, and possibly also a direct loss of hearing. As an acoustic neuroma grows larger and larger, it will begin to crowd the brain itself, as well as those nerves which manage facial expression and facial sensitivity. If an acoustic neuroma goes completely undetected and is allowed to continue growing, it can eventually put so much pressure on the cerebellum or brainstem, that a life-threatening situation can occur.
Causes of Acoustic Neuromas
There are two main causes of acoustic neuromas, the first of which is a sporadic form, and the second being related to a syndrome known as neurofibromatosis type II or NF2. Neurofibromatosis II is an inherited condition in which noncancerous tumors grow in the nervous system, and most of the time these noncancerous tumors are acoustic neuromas. For this inherited type of acoustic neuroma, it is fairly common for them to begin development in both of the patient’s ears, before the age of 30. This is a rare disorder that only makes up about 5% of all acoustic neuromas, meaning that the overwhelming majority of acoustic neuromas are of the sporadic form. Unfortunately, doctors and scientists do not yet understand what causes the sporadic form, although at least one risk factor has been identified as exposure to unusually high levels of radiation, primarily in the area of the neck and head.
Treatment for Acoustic Neuromas
There are three primary approaches to treatment of acoustic neuromas: radiation therapy, surgery, and observation. You can think of observation as ongoing monitoring or watchful waiting. Since acoustic neuromas are not cancerous and grow only slowly, there is usually not an immediate or urgent need for any more drastic form of treatment. What happens after the observation period will depend on how rapidly the acoustic neuroma grows, and what kind of impact it’s having on an individual.
Surgical procedures will take one of three tracks. Translabyrinthine surgery calls for an incision to be made behind the ear, so that a portion of the middle ear as well as the bone behind the ear can be removed, and this approach is generally used on tumors bigger than 3 cm. Sub-occipital surgery operates on the back of the head, and can be used for any sized tumors, and unlike translabyrinthine surgery which causes total hearing loss, sub-occipital surgery holds at least the potential for preserving your hearing. Middle fossa surgery also holds out hope for preserving a patient’s hearing, as it removes a small bone piece over the ear canal, so that tumors of a smaller size can be removed.
Radiation therapy is recognized as state-of-the-art treatment for acoustic neuromas, as it sends high radiation dosages directly at the tumor, while also limiting damage or exposure to all surrounding tissue. There are two types of radiation therapy which are generally used in the treatment of acoustic neuromas. The first of these is multi-session fractionated stereotactic radiotherapy (FRS). This delivers small doses of daily radiation over a period lasting several weeks, and is generally the more successful of the two radiation approaches. The second method for radiation therapy is known as single fraction stereotactic radiosurgery (SRS). In this approach, hundreds of small radiation beams are directed at the tumor in one comprehensive session. While this has the advantage of requiring only a single treatment session, it has historically been somewhat less effective than the FRS radiation therapy approach.
People who have hyperacusis hear things a little differently than people with relatively normal hearing. With this medical condition, ordinary sounds like running water, the ticking of a clock, or the timer alarm on your microwave not only sound extremely loud, but also can actually be painful. This doesn’t mean that their hearing is more acute, or that patients with this condition are able to hear more sounds than the rest of us – it just means that all normal sounds you may hear in a typical day are heard at a higher level of volume. This is not just a temporary inconvenience a with minor impact; it can literally have a profound effect on a person’s quality of life, because the condition doesn’t ever take a break – it’s there all the time.
How Does Hyperacusis Develop?
Scientists are not exactly sure what causes this condition to develop in any one person, but studies which have been conducted seem to point to exposure to one of several triggering conditions as a cause. One of the most prominent of these is noise related to a daily job routine: for instance, someone working in a factory with heavy machinery, or where a repetitive loud noise recurs throughout the eight-hour shift.
Traumatic head injuries are another possible cause of hyperacusis, with many of today’s hyperacusis patients having experienced some significant blow to the head in their past. Chronic ear infections are another culprit, because even though they can be cleared up with medication, the damage they do while the infection is rampaging can persist beyond the duration of the infection itself.
Migraine headaches are thought to be another possible cause of hyperacusis, since many current hyperacusis patients also experience migraines, or have had them in their medical history. There also seems to be a correlation between patients who have contracted Lyme disease or TMJ Syndrome in their past, although it is not known exactly what from those two conditions leads to the development of hyperacusis. Lyme disease is spread by a tick which can commonly be found in fields and woods, and may be brushed up against by a person. Temporomandibular Joint (TMJ) Syndrome is a disorder which causes pain in the muscles and joints of the jaw.
As far as the physiology behind the actual triggering of hyperacusis, that’s the part of the equation that scientists and researchers have yet to confirm. At present, it seems likely that the fibers of the ear which regulate sound have been somehow compromised, and that the auditory nerve has suffered significant damage. Another school of thought holds that the brain’s central processing system affects how the brain evaluates sound, and for some reason magnifies it beyond its true level. And naturally enough, since there are primarily these two major theories about what actually happens in hyperacusis, there is also another group of scientists who believe that a combination of those two is the real answer to the problem.
Relationship to Tinnitus
While most people have probably not heard of hyperacusis, the medical condition of tinnitus is probably much more well-known. While these two conditions are not at all same thing, they do have a relationship, in that both represent departures from the norm in the way that sounds are heard. People with tinnitus experience several different abnormal sounds in their hearing, sometimes even when there is no actual noise being generated in the surroundings.
This can be felt as a ringing noise, or some kind of whistling, hissing, or buzzing, and it’s easy to see how this can be so distracting that a person’s quality of life could easily be diminished. Although hard statistics are not available to support this, it is estimated that more than 60% of patients who have tinnitus also have hyperacusis. So in addition to hearing a persistent buzzing or whistling sound in the ears, a patient who experiences both of these medical conditions would also sense ordinary sounds at several times their true volume.
Having either one of these medical conditions could have a profound impact on your daily life, but just imagine being troubled by both of them at the same time! Patients who are known to suffer from both medical conditions generally find it extremely hard to just get through a normal day. As a result, there’s a strong tendency for such individuals to withdraw from life to a significant extent, and become socially isolated. This in turn, can easily slide into depression and add to the list of medical conditions the individual would have to deal with.
Treatment for Hyperacusis
Treating hyperacusis requires a two-pronged approach, but it does not really result in a cure for the condition. People who have hyperacusis are generally counseled so as to help lower their reactions to loud sounds, and a process known as acoustic therapy helps to retrain the ear to hear sounds at a more normal level. While there are no actual medical or surgical procedures at present which can offer significant help, some success has been achieved by the counseling/retraining program. Not surprisingly, the same approach has been used with tinnitus, with similar success.
Noise-induced hearing loss is a condition which currently affects about 10 million Americans. It is the most common preventable cause of hearing loss which is due to damage of the ear’s sensory nerve. The prevalence of noise-induced hearing loss and the number of people affected have steadily grown right along with the development of society—as more and more of man’s creations create noise pollution which damage a person’s hearing.
Probably most people understand the damage that can result from being close to a gunshot, but far fewer people are aware of potential damage from more mundane causes like leaf blowers, lawnmowers, traffic sounds, car alarms, music concerts, and even the stadium noise at a sporting event.
The truth is, any loud noises which are received by the ears over an extended period of time, no matter where they came from, can cause significant damage to the inner ear. Eventually this can lead to dizziness, ringing in the ears, some degree of hearing loss, and even issues unrelated to hearing, such as high blood pressure and an irregular heartbeat.
What is Noise-Induced Hearing Loss?
Noise-induced hearing loss is the condition which results from having an excess of sound energy reaching the inner ear. When the excess sound energy is temporary, any hearing loss is also likely to be temporary and reversible. A good example of this would be attending a loud rock concert where sound undergoes a great deal of amplification, and excess sound energy reaches every person in attendance, regardless of where they’re sitting.
It is fairly typical for someone attending a concert like this to completely recover within the next day or two, because the excess sound energy has dissipated. If that noise were to persist over a longer period of time, however, it is quite likely that the damage to the inner ear would be irreversible, and the listener would be subjected to a permanent loss of hearing.
It is also possible for excess sound energy to be so profound as to rupture a person’s eardrums, rendering them more or less deaf. Still more problems can be created if a person’s eardrums are shattered and he or she also develops severe dizziness, which is usually an sign that there is a perilymphatic fistula, i.e. an inner ear hole, created between the middle ear space and the inner ear fluid. Surgery in such cases may eliminate the dizziness, but the hearing loss is likely to remain permanent.
Prevention of Noise-Induced Hearing Loss
Two of the best kinds of protection for the inner ear are the simple devices we know as earplugs and earmuffs. Earplugs are small-sized devices made of various materials, which can easily fit into the outer ear canal to block sound reception. Since they come in many different shapes and sizes, earplugs can be fitted to virtually anyone’s ears, and the fit is very important because there must be an airtight seal in the ear canal to block excess sound energy from reaching the inner ear.
Earmuffs on the other hand, are devices fitted to the head, and they cover the entire outer ear to prevent sound energy from reaching the ear canal. These devices usually have an adjustable band which allows for a tight fit, and as in the case of earplugs, a tight fit is very important so as to make a good seal against excess sound energy.
The choice of which of these devices to use for any given situation is contingent upon which kinds of sounds need to be blocked. Earplugs are much more effective in providing protection from noises in the low frequency spectrum, whereas earmuffs offer better protection against noises on the high end of the spectrum. Either one will reduce the sound energy that reaches the inner ear by between 15 and 30 dB of sound, and when the two devices are used in tandem, a person wearing them can expect to have twice as much protection than by using either one alone.
Treatment for Noise-Induced Hearing Loss
Anyone who suspects that they may have sustained noise-induced hearing loss should seek professional advice from a doctor who has been trained in ear and hearing disorders. This kind of doctor will be able to diagnose the specific condition affecting a person’s hearing, and can recommend the most effective kind of treatment program.
Unfortunately, there is no real cure for noise-induced hearing loss, because damage to the inner ear is irreversible. There are various devices available which can help restore hearing if only one ear has been affected, and there are also amplification systems such as hearing aids, which can be used in certain situations.
There’s also a great deal of very promising research being conducted by such organizations as the National Institute on Deafness and Other Communication Disorders. One of the specific areas being researched now is how using antioxidants may be able to prevent hearing loss due to noise-induced causes, and may actually be able to restore relatively normal hearing.
Early results have already demonstrated that vitamin D and aspirin can reduce the effects of hearing loss when they are used prior to the event which produces excess sound energy. Other research conducted on laboratory animals has shown that exposure to loud noises does not result in hearing loss when the animals are provided with vitamins A, C, and E before being exposed to a loud noise.
If you’ve never heard of the term ‘hyperacusis,’ it refers to a condition in which a person’s normal tolerance to sounds in their everyday environment is severely diminished. With hyperacusis, the sound of a car braking at a traffic light can sound like a horrible screech, and a group of people applauding a speaker can sound like a huge thunderclap in a storm. In short, it’s as though someone was toying with the volume control of Life, and left it stuck on the highest setting – just about everything sounds extremely loud.
On the flip side, someone who has hyperacusis usually has lost most of the dynamic range generally associated with hearing, which means there isn’t much difference in the loudness of various sounds. For example, an actual explosion might sound very much like a book dropping off the edge of a table.
Most hyperacusis patients have a sensation of inner ear pain or a feeling of pressure in the ears which is similar to what you might feel when making a rapid descent in a commercial jetliner. On an airplane, this feeling can be easily overcome by yawning or chewing gum, but a hyperacusis patient feels this ear pressure all the time. This constant discomfort can have an enormous impact on a person’s life, affecting their job as well as their home life and relationships.
For someone with hyperacusis, operating a lawn mower, listening to the radio in the car, or running a vacuum cleaner at home may not be possible. This condition has less to do with volume, and more to do with particular sound frequencies, which can make attempts to muffle out noise entirely futile as well.
What can be done to help people who have hyperacusis?
Noise Has Color
The pink spectrum of noise is the one which most closely matches the broad range of sounds which we hear in our normal environment. That’s why treatment for patients with hyperacusis generally involves building up a tolerance to pink noise, rather than white noise, which includes higher frequencies. The higher frequencies are the ones most troubling for hyperacusis patients, so trying to build a tolerance to white noise is not nearly as effective an approach.
The goal of any program of sound therapy is to slowly and incrementally build up a tolerance to noise, but this can be a very frustrating and difficult experience for someone with hyperacusis. Many patients find that they just don’t have the patience to undergo this kind of slow therapy, and search for something that will produce faster, less uncomfortable results. If nothing helps, a patient may have few options other than to wear earplugs a majority of the time during waking hours.
How Sound Therapy Works
The whole idea of sound therapy is to get a person re-familiarized and tolerant of the noises which populate our day-to-day world. Sounds are delivered to the ears by one of the several methods, like listening to CDs with recorded everyday sounds. But this can be an inconvenient kind of session for the hyperacusis patient because therapy sessions should last at least two hours per day, and if you’re stuck with one CD for that long, it can get to be uncomfortable and restrictive.
An alternative method of sound delivery calls for custom-fitted sound generators made for your head and ears and having pre-recorded pink noise sounds played for the duration of your therapy sessions. With a sound generator, you’d be free to walk around and do other things, but it can be quite expensive. Whereas a pink noise CD costs less than $100, a sound generator delivering the same pink noise sounds might cost several thousand dollars.
Counseling: A Critical Part of Hyperacusis Therapy
Whichever kind of sound delivery system you choose, there is another essential part of sound therapy: counseling. Having a trained counselor or advisor can make all the difference sometimes, which can ease the difficulties and frustrations that come with sound therapy.
To begin, any sound therapy program requires a high degree of self-motivation from the participant, since no amount of cajoling will persuade a patient to undergo the uncomfortable sessions required. There will be days when the patient wants to shorten or skip the course, or even quit the process altogether. Those are times when a skillful counselor can serve as a cheerleader, and convince the patient to keep eyes on the prize and continue to forge ahead.
It is quite normal for hyperacusis patients to feel that the therapy is hurting them instead of helping since pink noise can be torturous to their hyper-sensitive ears. At times, it takes some skilled counseling to assure a patient that the process is doing them some good, and not harming their ears at all.
It is often a long and uncomfortable process getting re-acquainted with the sounds of our everyday world, but for the patient who sticks with it, it is possible to lessen and maybe even cure the adverse effects of hyperacusis.
According to the most recent report, tinnitus affects around 50 million people in America (to some extent). For the most part, people learn to live with the condition, but there are solutions available. This being said, some medications will make the issue worse which is why we recommend talking to a medical professional before you take action. For example, large doses of aspirin are a bad idea, and thousands of people go wrong every year thinking it will work.
What Is Tinnitus?
Firstly, we should address how tinnitus affects us and the best way to describe it would be a constant noise disturbance coming from inside your ears. Whether it’s a ringing or a whistling, the tinnitus patient is the only person who hears the sounds, making the condition border on maddening.
For most people, it’s a high-pitched ringing that causes the frustration, but you should know it doesn’t generally mean anything larger. Although there are misconceptions that tinnitus is a signal of something deeper in the ears or brain, this isn’t normally the case. As mentioned, only the sufferer will hear the noise, but there are rare cases where the noise comes from a musculoskeletal movement which will allow others to hear it too.
Ultimately, the only real symptom is the problem itself: the perpetual ringing in your ears. However, it’s important to note that the pitch and formation of the sound can differ from one person to the next. While some people note a low-pitched screech, others will suggest a clicking, chirping, hissing, whistling, whooshing, buzzing, pulsing, static, roaring, and perhaps even a musical tone to the sound.
Through the day and night, the volume can fluctuate, and patients notice it most at night. Tinnitus worsens at night mostly because they have nothing else to distract them. When at work and talking to people, we’re concentrating on other things but, when we’re trying to go to sleep, the ringing becomes the center of attention.
A little later, we’re going to take you through the treatment for tinnitus, but we first need to know the cause of the condition. With the word ‘tinnitus,’ we have a term that describes the actual sound regardless of its cause, which is important to remember. For proper treatment, it’s important to locate the cause to prevent the condition from returning.
If we were to look at averages and the most common problem, this would come down to damage/loss of the sensory hair cells in the cochlea of the inner ear. While the aging process is typically responsible for this, it can also occur after exposure to loud noises for an extended period. However, the sound we experience will alter depending on the loss of certain audio frequencies.
Once the brain receives fewer external stimuli around the lost frequency, it must adapt and replace the sound itself, and this is thought to be the reasoning for tinnitus. Since the auditory system isn’t providing all the right sound frequencies, the brain has to pick up the slack.
Elsewhere, other causes include traumatic brain injuries, ear infections, head/neck injuries, foreign object in contact with the eardrum, cardiovascular diseases, middle ear issues, temporomandibular joint (TMJ) disorders, and diabetes. As we said earlier, some medications will exacerbate the tinnitus, and these include some antibiotics, diuretics, aspirin, and ibuprofen.
If left untreated, tinnitus can lead to social isolation, depression, anxiety, and other problems, so treatment is important. With tinnitus, the first step will always be to locate the cause of the issue. After doctors run their tests and discover the problem, they’ll care for the ear infection, drop the ototoxic medications, treat the TMJ problems, etc.
There is no apparent cure for tinnitus induced by old age, so the focus moves to dealing with the sound and making it more bearable. With tinnitus retraining therapy (TRT), this retrains the auditory system, so the tinnitus sounds are accepted rather than disrupting your hearing. Although success isn’t guaranteed, 80% of people find some level of relief from tinnitus with TRT.
If this doesn’t work, your doctor will start dealing with the side effects such as depression, anxiety, and social isolation. With cognitive behavioral therapy (CBT), this ensures depression doesn’t get on top of tinnitus patients. Finally, ENT doctors suggest sound therapy, which exposes patients to constant low background noise to counteract the unpleasant inner ear audio disturbances. With some, they find relief in hearing aids because they amplify external sounds and drown out the tinnitus.
Imagine hearing a buzzing, clicking, or ringing sound that isn’t actually there. This nonexistent sound comes and goes as it pleases. This is tinnitus, a condition where a sound is only perceived by the affected individual. For millions of Americans, tinnitus is a pressing issue and an irritation. Tinnitus symptoms can be hard to live with and now it seems that the serotonin in a common antidepressant medication is making it worse.
How Tinnitus Symptoms Occurs
There are actually two different types of tinnitus – subjective and objective. If a person is hearing sounds that nobody else can, that is classified as subjective tinnitus. This is both an auditory and neurological issue caused by hearing loss and it accounts for 99 percent of all reported tinnitus cases.
Objective tinnitus is a bit different and much rarer than subjective tinnitus. This form of the condition is when a patient hears sound generated by the body’s internal structures and circulatory system. This type of sound can be heard by another who is close enough to the affected individual.
How Serotonin Affects Tinnitus
The constant irritation caused by tinnitus can take its toll. In fact, the hearing condition has a close association to psychiatric disorders. Scientists have found that depression and anxiety are connected to the severity of tinnitus. With this link being so apparent, researchers at the Oregon Health and Science University decided to see how a common anti-depressant affect the condition.
The anti-depressant is called selective serotonin reuptake inhibitors. It is used to treat depression, anxiety, and social phobia. This drug prevents a neurotransmitter called serotonin from breaking down in the body. Serotonin is a known to boost mood and happiness.
Through the examination of brain tissue in mice, the researchers were able to find out that high serotonin levels make tinnitus worse. The dorsal cochlear nucleus (the part of the brain that the scientist examined) is responsible for sensory integration. It is also the area of the brain where tinnitus develops. As serotonin levels increased, the brain’s neurons become hyperactive and hypersensitive.
What Researchers Had to Say About the Study
“We saw that the activity of those neurons went through the roof,” said senior author Laurence Trussell, Ph.D., a professor of otolaryngology at the OHSU School of Medicine and scientist at the OHSU Vollum Institute.
While tinnitus may be the cause of depression, the medication for the mental disorder only seems to make it worse. This can lead to the mental illness becoming even more of a recurring condition.
“If you’re a physician treating a patient for depression who also has hearing loss or tinnitus, you may want to be careful about prescribing a drug that compounds their feelings of anxiety,” said Trussell. “The SSRI may be enhancing the thing you’re trying to fix.”
Unfortunately, there is no cure for tinnitus symptoms. New technologies are being developed every day and researchers are looking into other options. Dr. Trussell’s team hopes to find a way to develop an antidepressant that does not affect the severity of the condition.
Tinnitus stems from hearing loss, obstructions in the middle ear, head and neck trauma, and other conditions. If you want to prevent tinnitus, the simplest way is to avoid situations that may harm your hearing. Loud noises can cause severe trauma that leads to hearing loss. You’ll also want to keep your ears clean and clear of foreign objects. See a qualified otolaryngologist if you want to evaluate your hearing.
Cognitive issues usually accompany hearing loss. That’s because hearing impairment makes it difficult for some to understand what others are saying. As you can imagine, this makes it hard to hold a conversation. During moments where a person with hearing loss is in a crowded or noisy place, understanding speech becomes an increasingly taxing. In order to solve this issue, scientists are developing cognitive hearing aids. The hope is that these devices can filter background noise and enhance voice recognition to make it easier for people to understand speech.
How Hearing Aids Work
Hearing aids are the primary medical devices used to improve hearing. They are used by people who have hearing damage or have developed hearing loss at some point in their lives. Around 48 million Americans report having hearing loss. Unfortunately, only 20 percent of these people actually use hearing aids.
While these devices cannot fully correct hearing loss, they make is easier to understand and process sound. Some hearing aids can cancel noise and the wind, enhance your spatial region, and highlight voice. These devices still have a long way to go. While some hearing aids are capable of suppressing background noise, they have trouble focusing on the speech of a specific person.
Working on Cognitive Hearing Aids
The goal of creating cognitive hearing aids is to focus on hearing one speaker over voices of many others. Hearing aids that can focus on a singular person can make it easier to understand someone in a crowded place. The cognitive hearing aids would have to connect to the brain to understand where to focus. They would also be quite the achievement.
At the Columbia University School of Engineering and Applied Science, researchers came together to determine how they can achieve this kind of auditory focus with hearing aids. The scientists looked at deep neural network models, which helped them separate multiple voices and determine which one the brain is focusing on. The speaker is then amplified so the user can hear them better. Ultimately, this improves auditory attention decoding (AAD).
“This work combines the state-of-the-art from two disciplines: speech engineering and auditory attention decoding,” says Nima Mesgarani, associate professor of electrical engineering and lead of the study. “We were able to develop this system once we made the breakthrough in using deep neural network models to separate speech.”
Previous studies helped the research team develop this new method. “Translating these findings to real-world applications poses many challenges,” notes James O’Sullivan, a postdoctoral research scientist working with Mesgarani and lead author of the study.
“Our study takes a significant step towards automatically separating an attended speaker from the mixture,” O’Sullivan continues. “To do so, we built deep neural network models that can automatically separate specific speakers from a mixture. We then compare each of these separated speakers with the neural signals to determine which voice the subject is listening to, and then amplify that specific voice for the listener.”
Final Thoughts on the Study
“Our system demonstrates a significant improvement in both subjective and objective speech quality measures — almost all of our subjects said they wanted to continue to use it,” Mesgarani says. “Our novel framework for AAD bridges the gap between the most recent advancements in speech processing technologies and speech prosthesis research and moves us closer to the development of realistic hearing aid devices that can automatically and dynamically track a user’s direction of attention and amplify an attended speaker.”
Hopefully, the cognitive hearing aids will convince those with hearing loss to use these devices. Hearing impairment can occur around the age of 65 years old. Using these devices can significantly improve their quality of life.
Unfortunately, there are many cases of infants with significant hearing loss. This loss of sound can occur at birth. Other times, hearing loss in infants develop slowly, becoming worse over time. It can be hard to pinpoint the cause of damage to the middle and outer ear. A loss of sound may occur due to birth defects, a buildup of fluid and ear wax, or because of a rupture to the eardrum. Researchers at the University of Colorado made a recent discovery, showing that early intervention of hearing loss can help your child later in life.
Early Intervention for Hearing Loss
Lead author Christine Yoshinaga-Itano is an audiologist and research professor in the Institute of Cognitive Science. With funding from the Centers for Disease Control (CDC), Yoshinaga-Itano’s team worked to assess the impact of Early Hearing Detection Intervention (EHDI) 1-3-6 guidelines. The Joint Committee on Infant Hearing developed these guidelines 17 years ago. These guidelines suggest that the following steps should be taken:
- All newborns should be screened for hearing loss within the first month.
- If the test is positive for hearing loss, parents should see a specialist within three months for an evaluated.
- Within six months, parents should start early interventions based on their child’s diagnosis.
About 96% of U.S. infants undergo the screening process. For one reason or another, some parents only go through with the first step. Several difficulties prevent parents from affording or meeting the requirements to improve their child’s hearing.
In a previous study, Yoshinaga-Itano looked at children with hearing loss in Colorado. The state has done well to promote early intervention for hearing loss.
Yoshinaga-Itano notes that “We showed that failure to diagnose hearing loss early can create an environmentally induced and preventable secondary disability, making children function much like children with cognitive delay.”
How Intervention Affects Speech
The research team at the University of Colorado at Boulder looked at 448 infants with hearing loss in both ears. The age of these children ranged from 8 to 39 months. Almost 58 percent of the kids have met the EDHI 1-3-6 guidelines.
To measure the impact of meeting these guidelines, the researchers how well these children learn vocabulary and language. The team measured the number of words the kids used when either speaking or using sign language via the Vocabulary Quotient (VQ) score. The difference was startling. Children who met the guidelines score significantly better than those who didn’t.
“We can’t change how much hearing a child has at birth or the educational background of a parent, but we can develop better systems,” says Yoshinaga-Itano. “Policymakers need to do whatever they can to make transitions from one step to another as seamless as possible so parents can meet the 1,3,6. And parents should know that there is an urgency to assuring that children who are deaf or hard of hearing have access to language as quickly as possible.”
Hopefully, the new study can show the need for parents to seek early intervention for their child. Like most diseases, the earlier you catch it, the easier it is to treat.