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Hearing & Eye Age-Related Diseases

The degeneration of the human body due to aging carries a variety of limitations including that of vital senses such as hearing and sight. Among the most common hearing impairments for older adults is the sensorineural hearing loss labeled Presbycusis. The term sensorineural in this context refers to the connection between the ear and the brain through the sensory system. Presbycusis is thus a problem of the inner ear and inhibits the transmission of stimuli from the ear as opposed to the degeneration of other components of the ear as an organ (Meiner & Yeager, 2019). Secondly, due to its sensorineural nature, Presbycusis is bilateral, meaning that both ears become impaired together and at approximately the same rate. The process of hearing loss in Presbycusis is both gradual and irreversible.

The primary known signs and symptoms of Presbycusis are observational based on the social cues and behaviors of patients. Typically, the patient will gradually increase the volume of electronic devices such as phones and TVs. Secondly, the older adult will tilt the head to cause the ears to face the listener (Meiner & Yeager, 2019). Cupping the ear to increase clarity or amplify voices is also common. Another common sign is for older adults to pay more attention to a speaker’s lips to compensate for the loss of hearing. The older adult may also begin to speak inordinately loudly based on the assumption that other people are having a similar hearing problem. In extreme cases, the patients may fail to respond to a speaker, more so when the speaker is out of sight because they do not notice that someone is speaking to them.

The etiology of Presbycusis includes gradual physiological or psychological damage that may result from the wear and tear of aging, chronic disease of the use of some drugs. A tangible reason for hearing loss such as nosocusis or sociocusis will rule out Presbycusis. Therefore, the primary mode of diagnosis is an elimination process that excludes all differential diagnoses. The clinician will seek to eliminate other causes of the symptoms outlined above, leading to the conclusion that Presbycusis is the primary cause (Meiner & Yeager, 2019). Among the common differential diagnosis is a noise-caused hearing problem, caused by exposure to loud noises for an elongated period. Physical damage such as an injury, genetic predisposition, heart disease, and cardiovascular conditions also need to be ruled out.

Since Presbycusis is both gradual and irreversible, the best form of intervention is early detection, management, and patient education. Patient education is key in both early intervention and management. Since Presbycusis is common, I would teach the patient to detect the advent of the disease early such as noticing when the TV is inaudible to the patient yet everyone else can hear it. Patient education is also vital in enabling the patient to avoid anti-social behavior such as shouting or scolding people for speaking softly. The second form of intervention is the use of technology, such as hearing aid to mitigate the impact of hearing loss. The third intervention is surgery to improve hearing and repair part of the degeneration, which is suitable in extreme cases of hearing loss for socially or professionally active older adults.

From an aging perspective, three different retinal and macular diseases are early, intermediate, and late age-related macular degeneration (AMD) (Al-Zamil & Yassin, 2017). All three conditions stem from the gradual degeneration of the macula, a pigmented area near the eye’s retina, and the retina itself. The retina is the inner part of the eye, which translates light into electric impulses for transmission to the brain. Early AMD is asymptomatic and may not be detected without advanced image-based diagnostic tools. Intermediate AMD may cause some vision loss and is detectable through abnormalities in retinal pigmentation (Al-Zamil & Yassin, 2017). Late AMD includes the development of atrophy or the advent of neovascular disease. In late AMD, actual visual loss begins for the patient. Another common classification of AMD is wet and dry AMD, which separates nonexudative AMD as dry AMD from all other types of AMDs being termed as wet.

References

Al-Zamil, W. M., & Yassin, S. A. (2017). Recent developments in age-related macular degeneration: A review. Clinical Interventions in Aging, 12, 1313–1330. https://doi. 10.2147/CIA.S14350 (Links to an external site.)

Meiner, S. E., & Yeager, J. J. (2019). Gerontologic nursing (6th ed.). Elsevier.