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PubMed1993

Cochlear pathology in presbycusis.

A survey of the temporal bone collection at the Massachusetts Eye and Ear Infirmary reveals 21 cases that meet the criterion for the clinical diagnosis of presbycusis. It is evident that the previously advanced concept of four predominant pathologic types of presbycusis is valid, these being sensory, neural, strial, and cochlear conductive. An abrupt high-tone loss signals sensory presbycusis, a flat threshold pattern is indicative of strial presbycusis, and loss of word discrimination is characteristic of neural presbycusis. When the increments of threshold loss present a gradually decreasing linear distribution pattern on the audiometric scale and have no pathologic correlate, it is speculated that the hearing loss is caused by alterations in the physical characteristics of the cochlear duct, and the loss is identified as cochlear conductive presbycusis. It is clear that many individual cases do not separate into a specific type but have mixtures of these pathologic types and are termed mixed presbycusis. About 25% of all cases of presbycusis show none of the above characteristics and are classified as indeterminate presbycusis.

Aged↗
PubMed1986

Hearing loss due to aging (presbycusis).

Presbycusis is the progressive hearing loss caused by histologic changes due to aging. Schuknecht described four histopathologic types of presbycusis and correlated these findings to audiometric data. In a retrospective study, some strict criteria were set to distinguish the "pure" cases of presbycusis in a group of 1,181 subjects, 50 years of age and older, seen in our Audiology Clinic over one year; 91 subjects were found to meet these criteria. An attempt was made to fit the pure tone threshold curves into the types described by Schuknecht and correlate these curves to speech discrimination, tone decay, recruitment, age and sex of these subjects. It was found that: (a) only 50% of these audiograms could be fitted into the described histopathologic types, suggesting that in 50% of the subjects, presbycusis was caused by more than one degenerative process; (b) in 86% of subjects, speech discrimination was excellent or good in quiet; this test therefore may not reflect the difficulties presbycusis have in understanding speech under adverse auditory conditions; (c) subjects with flat pure tone threshold curves had generally good discrimination; (d) no differences were found between males and females; and (e) tests for tone decay and recruitment showed that in most cases the hearing loss was due to cochlear pathology, but these data do not exclude the possibility of central auditory involvement.

Age Factors↗
PubMed1982

Differentiation of types of presbycusis using the masking-level difference.

Masking-level differences in quiet at 500 Hz were used to demonstrate evidence of elevated noise levels within the auditory systems of subjects with assumed neural presbycusis. The following five groups of subjects were evaluated: normal-hearing young and old adults; and older adults with metabolic, sensory, or neural presbycusis. The group with assumed neural presbycusis--that is, bilateral high-frequency sensorineural hearing loss and poor word-recognition performance--had masking-level differences (a) in quiet that were significantly larger than those for the other groups and (b) in noise that were significantly smaller than those for the other groups. The data suggest that elevated internal noise levels accompany neural presbycusis.

Adolescent↗
PubMed1984

Comparisons between the median hearing threshold levels for an unscreened black nonindustrial noise exposed population (NINEP) and four presbycusis data bases.

The median hearing threshold level (HTL) data representing an unscreened black nonindustrial noise exposed population (NINEP) are compared to the median HTL data of three previously established presbycusis data bases by Hinchcliffe, Corso, and Rosen, and the data base developed by Robinson and Sutton. The data bases are all normalized relative to age 18. Comparisons are made between the black NINEP and the presbycusis data base HTLs for different sex and age groupings. The unscreened black NINEP exhibits median HTLs similar to those of the presbycusis data bases for ages less than approximately 35-45 years. However, for age groupings greater than 35-45 years, the median HTLs of the black NINEP are generally lower (better hearing) than those of the referenced presbycusis data bases even though this data base exhibited significant nonindustrial noise exposures, and medical and pathological problems which were not screened out of the population.

Adult↗
PubMed1977

Presbycusis: what is it?

The history and current misusage of the term presbycusis is discussed and current knowledge of pathology associated with presbycusis and aging are reviewed. A study involving retrospective analysis of audiometric data and clinical information on three groups was performed. Results suggest that a group of individuals previously identified as "presbycusic" probably represent undiagnosed cases of familial or genetic related hearing loss. We urge as thorough an identification of correct diagnosis as possible, thus reserving the term "presbycusis" for those rare, soley age-related cases of sensorineural loss.

Aged↗
PubMed1989

[Analysis of cochlear manifestations of presbycusis by acoustic oto-emissions. Review of the literature].

This paper analyzes the results published in the literature about the physiopathology of presbycusis studied by evoked oto-acoustic emissions. Evoked oto-acoustic emissions were recorded in a group of normally hearing-subjects and a group of patients demonstrating sensorineural hearing loss due to presbycusis. Correlations studies were made between the incidence and threshold of evoked oto-acoustic emissions and (i) the age, (ii) the tonal audiometric thresholds and (iii) the speech audiometry. Complementary informations on outer hair cell degenerative changes in presbycusis could be deduced from these data.

Acoustics↗
PubMed1985

[Hearing in advanced age: critical view of so-called presbycusis].

Presbycusis cannot be defined nosologically as an uniform disease. The computed threshold curves of the age dependent high-frequency hearing loss should not conceal the fact that the degree and form of the hearing loss vary greatly within the age groups. The pathological appearances also vary; degenerative changes vary in site and extent and are not limited to the cochlear structures, but are also found in all parts of the auditory system. The etiology of presbycusis can scarcely be attributed to the physiological senile degeneration of cochlear or central nervous structures alone because epidemiological studies suggest that without additional endogenous and exogenous noxious effects the hearing loss progresses more slowly than under the influence of these effects. Therefore, presbycusis, in the sense of a socially handicapping hearing loss, is not an invariable lesion of the auditory system (mainly of the inner ear) due to a combination of different etiological factors. There are only two possible treatments: (1) elimination of exogenous and endogenous noxious effects in the hope of delaying the progress of the hearing loss and (2) fitting of a hearing aid. The open high-tone CROS-aid seems to provide a sufficient discrimination gain which is especially valuable for the typical high tone hearing loss in aged people. The necessity for a careful follow-up is emphasised.

Aged↗
PubMed1982

Presbycusis: the need for a clinical definition.

The term presbycusis is vague and needs specific signs and symptoms for its definition. Several types of presbycusis, depending on the type of lesion, have been proposed. This article suggests a working definition of "classic presbycusis," which may be defined as a syndrome involving (1) a bilaterally symmetric sensorineural hearing loss, (2) absent or partial recruitment, (3) negative noise history, and (4) poorer speech discrimination than indicated by pure tones (phonemic regression).

Adolescent↗
PubMed1987

Aging and the auditory brainstem response in mice with severe or minimal presbycusis.

Threshold, latency, and amplitude of the auditory brainstem response (ABR) were obtained with filtered noise pips in young and aging C57BL/6J mice (to 16-months), which undergo severe progressive age-related sensorineural hearing loss (presbycusis) and CBA/J mice (to 19-months), which show only mild loss late in life. Aging per se (CBA mice) is not associated with significant changes in ABR parameters. Presbycusis, in aging C57 mice, is associated with increased thresholds; there is a trend toward increased latencies, but only when threshold elevations are substantial. Amplitudes of early waves, but not late waves, decrease greatly in aging C57 mice. In young C57 mice, amplitudes of early ABR waves vary monotonically with intensity, while amplitudes of later waves (IV and V) have a relatively flat, or even nonmonotonic, relationship to intensity; in older C57 mice, all waves have monotonic intensity functions. ABR parameters are not affected by gender in either strain. The mouse models can help to clarify some inconsistencies in the human literature on aging and the ABR.

Age Factors↗
PubMed1991

Presbycusis and noise-induced permanent threshold shift.

Bies and Hansen [J. Acoust. Soc. Am. 88, 2743-2754 (1990)] have proposed an alternative formulation of the relationship between noise exposure and noise-induced hearing impairment to that presented in International Standard ISO 1999, in which they assume that presbycusis and noise-induced permanent threshold shift (NIPTS) are additive on an antilogarithm basis. Data concerning deterioration in hearing threshold levels at 4000 Hz due to aging in war veterans with NIPTS do not support the Bies and Hansen assumption but provide support for the formula for combining presbycusis and NIPTS incorporated in International Standard ISO 1999.

Adult↗
PubMed1985

Central presbycusis.

The phenomenon of central presbycusis has been investigated employing a central auditory battery in elderly individuals with essentially normal hearing. The studies indicate a progressive loss in central auditory competence measured by simultaneous binaural challenges and frequency and temporal distortion tests. The rate of failure is related to age, on the whole, but there is increasing variability from the normals with seniority. The hearing disability in noise or speech competitive environments is explained by these data. Auditory disabilities related to poor articulation and rapid speech presentation are identified by other tests in the battery. Central presbycusis, in addition to the peripheral form, does exist and further compounds the hearing disorder in many elderly.

Age Factors↗
PubMed1990

Central physiological correlates of ageing and presbycusis in mice.

Responses of neurons in the central auditory system of ageing mice suggest several sources of age-related problems in hearing. The central representation of frequency (tonotopic organization) is disrupted in mice with presbycusis, implying a cause of problems with frequency coding. In very old mice with only minimal hearing loss, normal-responding neurons co-exist with "sluggish" neurons, which suggests there is a process of attrition that affects some neurons more than others. Spontaneous activity increases in neurons of older mice, implying a decrease in the physiological signal-to-noise ratio. The effects of age-related hearing loss are more severe in the ventral cochlear nucleus than in the dorsal cochlear nucleus, suggesting that various functional circuits may be more or less vulnerable to presbycusis.

Acoustic Stimulation↗
PubMed1986

Effects of presbycusis and other types of hearing loss on auditory brainstem responses.

Auditory brainstem responses were studied in 373 healthy individuals of various ages and with sensorineural hearing loss of differing degrees. 209 subjects were elderly and had a hearing loss which included a component of presbycusis. The remainder were young or middle-aged with cochlear hearing loss. Altogether 606 ears were tested. The old individuals had generally longer ABR wave latencies than the young subjects. The I-V interpeak latency (IPL) was also prolonged in the older age groups compared with the group of younger individuals, except for subjects with pronounced hearing loss. The results of the study indicate that an age-related dysfunction of the auditory pathway in the brainstem can be present in presbycusis.

Adult↗
PubMed1991

Is there a relationship between presbycusis and hyperlipoproteinemia? A literature review.

This paper reviews several articles on the subject of presbycusis, and its relationship to dietary lipids--particularly lipoproteins--as well as hypertension, and noise exposure. Although most studies do reach some sort of consensus, the evidence supporting a relationship between presbycusis and hyperlipoproteinemia (HLP) remains questionable. The etiology of such a connection has not been properly tested, probably due to inadequate laboratory techniques. Future opportunities for exploring this subject are considerable, both in the laboratory and clinical setting. Possible treatment measures for "HLP-hearing loss" are also reviewed.

Adult↗
PubMed1988

[Alterations of speech audiometry in presbycusis brought about by cochlear acoustic emissions].

Click-evoked oto-acoustic emissions (EOEs) and speech audiometry were recorded in a group of normally hearing subjects (n = 56 ears), and a group of patients demonstrating sensorineural hearing loss due to presbycusis (n = 39 ears). Correlations were made between detection-threshold of EOEs, speech reception threshold (i.e., lowest hearing level at which the subject can repeat 50% of a message), and discrimination score (i.e., discrimination score determined 35 dB above the speech reception threshold). EOEs have never been observed when speech reception threshold was equal to or greater than 35 dB HL. EOEs were always found when speech reception threshold was equal to or lower than 25 dB HL. Moreover, the detection-threshold of EOEs increased when increasing speech reception threshold. On the other side, there was not a good correlation between the discrimination score and the detection-threshold of EOEs. Thus, complementary information on outer hair cell degenerative changes in presbycusis could be deduced from these data.

Adolescent↗
PubMed1982

[Time resolution ability of the ear in presbycusis and sensorineural hearing disorders].

In psychoacoustical and electrophysiological experiments the time resolution ability in monaural and binaural hearing was investigated for defined signal parameters. The binaural stimulation is characterized by signals of different structure (dichotic stimulation). With regard to different functional changes in the peripheral and central areas of the hearing organ caused by presbycusis, these investigations confirm that there are similar changes in time resolution processes which may influence speech discrimination in presbycusis to a high degree. In patients with sensorineural hearing loss time resolution ability was reduced only slightly. No defined correlation between lack of time resolution ability and type or degree of hearing loss could be established.

Adult↗
PubMed1978

Remote masking in presbycusis.

Remote Masking (RM) (a rise in threshold for low-frequency tones when the ear is exposed to a high intensity noise band of high frequency) has been attributed to mechanical nonlinear distortion of the cochlear partition, as an effect of the envelope of a nonuniform signal. Clinical studies using RM have revealed RM is normal only when both the endolabyrinthine pressure and the cochlear hydrodynamics are normal. Increasing the stiffness of the cochlear partition affects adversely the mechanism of motion of the cochlear duct and reduces RM values. We studied RM in normal young Ss and in patients with presbycusis in order to determine whether aging of the inner ear also induces stiffness of the cochlear partition. In presbycusic Ss the RM values were indeed reduced symmetrically in both ears and progressively as a result of aging. Thus RM demonstrates the existence of cochlear conductive presbycusis and can be considered a useful test of stiffness of the cochlear partition.

Adolescent↗
PubMed1983

Demonstration of presbycusis across repeated measures in a nonhuman primate species.

The progress of age-related hearing loss in three 31-yr-old, two 24-yr-old, and two 9-yr-old rhesus monkeys (Macaca mulatta) was repeatedly examined over a period of 3 yr. Pure-tone audiograms for seven frequencies, .125, .500, 2.000, 4.000, 16.000, 22.667, and 32.000 kHz, were obtained through the use of the psychophysical tracking method. Analysis indicated the presence of presbycusis in the older animals. Animals demonstrating presbycusis showed a progressive decrement in the ability to detect higher frequencies and an overall hearing loss at all frequencies.

Aging↗