A number of age-related changes occur in the ear. Membranes in the middle ear, including the eardrum, become less flexible with age. In addition, the small bones in the middle ear, the ossicles, become stiffer. Both these factors somewhat decrease hearing sensitivity but are not thought to cause significant impairment. Changes also occur in the inner ear but it is unclear whether is it aging or exposure to environmental noise that causes these problems that result in hearing loss.

Changes in the middle ear with advancing age also contribute to a weakening sense of balance. The vestibular system is responsible for our sense of balance. The vestibular apparatus begins to degenerate with age in a similar way to the hearing apparatus. Equilibrium becomes compromised and older individuals may complain of dizziness and find it difficult to move quickly without losing their balance.

Presbycusis

Presbycusis-- literally "old man's hearing"-- is the most common form of hearing loss with aging. It is characterized by a decrease in perception of higher frequency tones and a decrease in speech discrimination. The magnitude of presbycusis varies widely and it is hard to determine how much of the hearing loss is due to aging and how much is due to exposure to environmental noise, ototoxic drugs, or chronic age-related conditions such as hypertension and diabetes.

Beginning around age 55, most older adults experience a loss in threshold sensitivity to pitch as the very high frequencies are lost. The higher frequency consonants, such as t, p, k, f, s and ch, are no longer heard due to the sensitivity loss in the high frequencies. In addition, elders have more difficulty in understanding speech, especially when there are competing sounds such as background noise.

Tinnitus

Tinnitus refers to a chronic ringing, buzzing, tinkling, humming or other noise in the ears that only the individual can hear. Nearly 36 million Americans have tinnitus. Tinnitus is more common among older adults because it may represent a lifetime of exposure to loud noise. Treatable causes of tinnitus include high blood pressure, wax in the ear canal, or some medications (e.g., aspirin, antibiotics, antidepressants). Tinnitus may also be a symptom of ear infection, allergy or thyroid problems. If a cause can be identified then tinnitus may be curable. More often though the cause of tinnitus is unclear. Although there are no effective drug therapies, you can do several things which may help:

• use a masking devices that produces a noise to distract you from the tinnitus
• avoid stimulants such as caffeine or nicotine which can increase tinnitus
• limit stress and use biofeedback or relaxation techniques
• join a support group.