Characteristics of Presbycusis in A Super-Aged Society

Abstract

Objectives: To estimate presbycusis characteristics and investigate whether any changes have occurred in the pathophysiology of presbycusis over the decades. Methods: This was a retrospective cross-sectional observational study. A total of 186 patients aged ≥ 65 years were selected for the elderly group; they included patients with mild-to-moderate sensorineural hearing loss of unknown cause. For the middle age group, 56 patients aged 30–50 years who had positive results for the recruitment phenomenon were selected as controls. The participants’ age, sex, pure-tone hearing levels of air conduction (125–8000 Hz), maximum speech discrimination score (SDSmax), and the presence or absence of the recruitment phenomenon were investigated based on medical records. Results: Sixty-one patients in the elderly group were aged ≥ 80 years. Hearing levels were significantly better in male patients in the low-frequency range and significantly better in female patients in the high-frequency range (p < 0.01). In the elderly group, the proportion of patients with poor speech discrimination was 52.4–70.2%. The SDSmax was significantly higher in female patients than in male patients (p < 0.01). The proportion of patients with the recruitment phenomenon was 93.5%. The audiometric hearing pattern was dominated by a gradual-down slope, high-frequency-impaired, and flat patterns. There were significantly more female patients with a flat pattern and significantly more male patients with a gradual-downslope pattern and U-shaped pattern (p < 0.01). Age, sex, mean pure-tone hearing level, and audiometric hearing pattern significantly affected the SDSmax (all, p < 0.05), as evaluated with multiple regression analysis. Conclusion: More than half of the elderly patients with mild or moderate hearing loss were estimated to have retrocochlear damage. The age of hospital visitors for presbycusis was found to have increased over time. However, the distribution of pathophysiologies was not different from that in previous studies performed with relatively younger patients. This suggests a shift of patients presenting with presbycusis toward an older age range.