As nurses, it is essential to understand health over the course of the human lifespan. In the currently ageing population, it is especially important to learn more about the ageing process.
One such aspect of ageing involves sensory changes.
You may already be well aware that many of the older people you care for appear to have some sensory issues, such as poor vision or hearing. Take a moment to investigate the mechanisms behind sensory loss in ageing.
You may be able to recall a time when a loud, high pitch noise was heard by you, but an older person failed to notice it.
Presbycusis is the term used to describe the ageing-related hearing loss that can include the decreased ability to hear high frequency noises (Medline 2014).
Hearnet (n.d.) states that as many as 30-40% of older adults have presbycusis. They (Hearnet n.d.) also claim that to a person with presbycusis, it may sound like people are mumbling when speaking to them, despite their speech being at a seemingly adequate volume.
Other hearing concerns that you may have come across for older clients could include troubles hearing when background noises are present (Medline 2014) – this may be especially difficult in a busy, noisy, hospital setting with buzzers going off and people chatting.
Tinnitus is when the person experiences ongoing, unusual noise, sometimes due to wax accumulation or the use of medications that injure ear structures (Medline, 2014). Again, this is a fairly common condition amongst older people (Medline, 2014).
Yamasoba et al. (2013) state that there is an increasing indication amongst animal studies that supports the idea that collective oxidative stress may harm macromolecules like mitochondrial DNA; thus, leading to AHL/presbycusis.
Risk Factors for Age-Related Hearing Loss (AHL) Include:
- Cochlear ageing
- Co-morbidities such as smoking and atherosclerosis
- Environment (e.g. noise pollution)
- Genetic susceptibility
(Yamasoba et al. 2013)
‘Exposure to noise is known to induce excess generation of reactive oxygen species (ROS) in the cochlea, and cumulative oxidative stress can be enhanced by relatively hypoxic situations resulting from the impaired homeostasis of cochlear blood supply due to atherosclerosis, which could be accelerated by genetic and co-morbidity factors. Antioxidant defense system may also be influenced by genetic backgrounds.’
(Yamasoba et al. 2013)
AHL reportedly significantly contributes to disability in the United States of America and it is estimated that around 66% of people aged 70 years or older are affected by loss of hearing sensitivity (Bainbridge & Wallhagen 2014).
Hearing loss is unfortunately linked to an array of issues, some of which are: decreased quality of life; declined physical functioning; poorer communication; and decreased cognitive functioning (Bainbridge & Wallhagen 2014).
Lin et al. (2013) similarly found a connection between hearing loss and cognitive decline and impairment for ‘community-dwelling’ older adults, highlighting that there is a need for further research into why this phenomenon occurs.
Another potential area of concern was raised by Mick et al.’s (2014) study in the USA that found women between ages 60-69 years old with increased hearing loss were more likely to be socially isolated.
Bainbridge and Wallhagen (2014) convey that most people with hearing loss do not wear their hearing aids; thus, missing an opportunity for potential improvements in their quality of life.
Hearing loss is a costly condition to care for, which may be even more alarming considering the ageing population (Bainbridge & Wallhagen 2014).
Management of AHL / Presbycusis
Suggested management of presbycusis can include seeing an audiologist or audiometricist to assess if hearing loss is occurring, and whether hearing aids or other technology (e.g Hearables) are needed (Hearnet nd). Some audio technology, such as Hearables or Wearables allow the user to connect with Bluetooth devices like their smartphones (Hearnet, nd.b)! They can even help to share information via social media and monitor and record biometric data (Hearnet nd.b)!
Banks (2017) has a list of some of the hearable technology devices and their specifications, many of which show exciting new possibilities for an ageing population in terms of quality of life, health monitoring, and socialisation.
‘Biometric personal identification. NEC recently announced a technology that utilizes sound waves to acoustically recognize and identify a person (i.e. the owner of the hearing device) based on the size and shape of their ear.’
Amazing opportunities for the future of healthcare exist in the field of wearable technology. One such example are ‘hearables’, which will undertake a complete set of vital signs, as well as electrocardiograms (ECGs) and even electro-encephalograms (EEGs) (Banks, 2017)!
Visualise how easy it could be in the future for health professionals to monitor clients in their usual daily routines, or when they are experiencing episodes of acute illness or ongoing chronic diseases.
Banks (2017) also suggests that hearing technology is being made increasingly invisible/hidden, and that technology could allow people to hear above regular levels. There is also a planned attempt to create live translations! Imagine how helpful this could be for health professionals interacting with stakeholders that speak in languages other than English.
The future looks bright for hearing technology and its potential applications. As a health professional, I feel that there are some interesting and exciting innovations being developed that could greatly improve quality of life or wellbeing for many people. These new technologies appear to be particularly fascinating in light of the ageing population and its related healthcare requirements.
With a background in aged care, I find this very motivating and can think of various applications for such products. I can picture much more engaging diversional therapy activities, physiotherapy sessions, and ways to calm the environment (e.g. relaxation audio) for people that are experiencing anxiety, discomfort or confusion.
How could you apply hearable technologies in your field?
- Bainbridge, KE & Wallhagen, MI 2014, ‘Hearing loss in an aging American population: extent, impact, and management’, Annual Review of Public Health, vol. 35, pp. 139-52, viewed 9 March 2017, http://www.annualreviews.org/doi/full/10.1146/annurev-publhealth-032013-182510
- Banks, W 2017, ‘The complete guide to hearable technology in 2017’, Everyday Hearing, 23 January, viewed 9 March 2017, https://www.everydayhearing.com/hearing-technology/articles/hearables/
- Hearnet Online n.d.a, Presbycusis, Hearnet Online, Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, VIC, viewed 9 March 2017, https://hearnet.org.au/hearing-problems/presbycusis
- Hearnet Online n.d.b, Hearables, Hearnet Online, Department of Audiology and Speech Pathology, The University of Melbourne, Carlton, VIC, viewed 9 March 2017, https://hearnet.org.au/hearing-technology/hearables
- Lin, FR, Yaffe, K, Xia, J, Xue, QL, Harris, TB, Purchase-Helzner, E, Satterfield, S, Ayonayon, HN, Ferrucci, L & Simonsick, EM for the Health ABC Study Group 2013, ‘Hearing loss and cognitive decline in older adults’, Jama Internal Medicine, vol. 173, no. 4, pp. 293-9, viewed 9 March 2017, https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1558452?buffer_share=f2d51&utm_source=buffer
- Medline Plus 2014, Aging changes in the senses, Medline Plus, US National Library of Medicine, Bethesda, MD, viewed 9 March 2017, https://medlineplus.gov/ency/article/004013.htm
- Mick, P, Kawachi, I & Lin, FR 2014, ‘The association between hearing loss and social isolation in older adults’, Otolaryngology – Head and Neck Surgery, vol. 150, no. 3, pp. 378-84, viewed 9 March 2017, http://journals.sagepub.com/doi/abs/10.1177/0194599813518021
- Yamasoba, T, Lin, FR, Someya, S, Kashio, A, Sakamoto, T & Kondo, K 2013, ‘Current concepts in age-related hearing loss: Epidemiology and mechanistic pathways’, Hearing Research, vol. 303, pp. 30-8, viewed 9 March 2017, http://www.sciencedirect.com/science/article/pii/S037859551300035X