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Characteristics of Hearing in Elderly People
The authors define the term presbycusis and discuss the prevalence of hearing loss in elderly people, its etiology, and methods of diagnostics (anamnesis, evaluation of the peripheral and central parts of the hearing system). The authors emphasize that central auditory processing disorder (CAPD) significantly impairs speech perception in elderly people and makes difficult the rehabilitation of patients with presbycusis. The possibility of improving speech intelligibility by using auditory training is considered. Improved functioning of the central auditory pathways in hearing aid (HA) users with moderate to moderately severe chronic sensorineural hearing loss (SNHL) and symptoms of CAPD was shown after the auditory training with the use of two approaches (“bottom-up” and “top-down”). The algorithm of the auditory training was designed based on distinction between nonverbal and verbal stimuli of varying complexity, as well as tasks to improve memory (e.g., memorizing poetry). The benefits of the auditory training in the rehabilitation of HA users with low speech intelligibility were demonstrated. Improvement of speech intelligibility in elderly patients with SNHL proves that plasticity of the auditory regions of the brain remains possible throughout the life. Options of the presbycusis prophylaxis are summarized.
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