Hearing Loss


  • Hearing loss is the third most chronic health condition in the older population.  Tinnitus is the ninth. However; screening for hearing loss is not routine.  Only about 15% of primary physicians screen for hearing loss during a physical.  So hearing loss is more prevalent than visual loss; yet, it is more likely to be referred to an ophthalmologist than an ENT or audiologist.
  • The prevalence of hearing loss is on the rise due to longer life expectancies. It is an invisible condition that if left untreated can have severe detrimental effects on one’s overall quality of life.
  • The primary treatment of adult hearing loss is the use of hearing aids; yet, hearing instruments remain underutilized. Only about 25% of people 65+ who could benefit from hearing aids use them.
  • Most people do not seek treatment until 5-7 years after experiencing initial symptoms.
  • Research indicates that mild to moderate sensorineural hearing loss causes a decrease in the overall quality of life in older adults.
  1. Hearing loss can result in a loss of social independence and diminish the quality and quantity of social interaction.
  2. May impact life satisfaction and on one’s self-esteem
  3. Increased hearing loss is associated with clinical depression and decreased quality of life.
  • Hearing aids have proven to be valuable in improving quality of life and the communicative and psychosocial effects of hearing loss
  • Yet hearing aid remain stygmatizing because:
    • Vanity
    • Price
    • Associated with old age
    • Associated with disability
    • Associated with less intelligence



Conductive: Sound is not transferred efficiently through the outer ear canal, eardrum and/or the middle ear.  This type can usually be treated medically or surgically. Some causes:

  • Ear infection (outer or middle)
  • Eustachian tube dysfunction
  • Perforated eardrum
  • Benign tumors
  • Impacted earwax
  • Presence of a foreign body (i.e. cotton swabs / battery)

Sensorineural: Occurs when there is damage to the inner ear (cochlea), or to the nerve pathways from the inner ear to the brain.  As we age our neural structures break down and we do not interpret sound waves as efficiently.  Generally, sensorineural hearing loss cannot be medically or surgically corrected. This is the most common type of permanent hearing loss.  Some causes:

  • Illnesses
  • Drugs that are toxic to hearing
  • Genetic or hereditary
  • Aging
  • Head trauma
  • Exposure to loud noise

Mixed: A combination of conductive and sensorineural

A hearing impairment becomes a disability when everyday hearing abilities and communication performance are affected.  

The degree of the disability depends on the type and severity of the hearing loss with regard to lifestyle, social circumstance and career status.  

The impairment or disability becomes handicapping when it causes a decline in psychosocial functioning including anxiety, depression, embarrassment, frustration, reduced self-worth, stress in relationships and restrictions in social activities and participation .


  1. Normal hearing: < 25 dB
  2. Mild hearing loss: 26-40 dB – Will miss consonant sounds; can miss up to 40% of   spoken message; amount of difficulty depends on noise level, distance from speaker, and configuration of hearing loss; a hearing aid will be beneficial
  3. Moderate hearing loss: 41-55 dB – Can understand one-on-one conversation at a distance of 3-5 feet; may miss up to 75% of the speech message; will benefit from hearing aid
  4. Moderately-severe hearing loss: 56-70 dB – May miss all of the spoken message even face-to-face; group conversation will be very difficult; will benefit amplification
  5. Severe hearing loss: 71-90 dB – will probably not hear voices unless they are very loud; without a hearing aid speech will not be understood through listening alone
  6. Profound hearing loss: 91 dB or greater – even loud sounds may not be detected without amplification; will rely on speech reading while communicating