A handy guide to understanding hearing loss

One in three people over age 60 and half of those older than 85 have some hearing loss. But with ever more sophisticated technological advances, you can dramatically improve your hearing, no matter how old you are.

• The most common cause of hearing loss is a normal age-related condition called presbycusis, which is derived from the Greek for "old hearing." The ancient Greeks got it right: hearing often degenerates with age. A major contributing factor can be exposure to loud noises at work or play. But you don't have to attend countless concerts or noisy ­political rallies to lose your hearing. It can occur naturally, when receptor cells in the inner ear wear out over time. And there appears to be a genetic link, as hearing loss tends to run in families.
• Hearing is all about vibrations. Sound waves are vibrations that move through the air. Once they enter the human ear, they go through the eardrum and then the middle ear, where three tiny bones called the ossicles act as an amplifier. Once ushered into the inner ear, the vibrations move through a fluid in the snail-shaped hearing center called the cochlea, which contains tiny, specialized hair cells. The fluid stimulates these hair cells, which produce nerve impulses that are sent to the brain.
• Depending on how the fluid moves the hair cells, your brain is able to correctly interpret various sounds, such as distinguishing vowels from consonants or differentiating between a dog barking, a baby crying or a spouse speaking. As people age, the hair cells can degenerate. Usually, the first sign of hearing loss is difficulty with high-frequency sounds, like birds singing or children’s voices. You also may notice problems understanding what someone is saying when there’s a lot of background noise, maybe in a crowded restaurant or when a television is on.
• Exposure to loud noises also can damage hair cells, causing hearing loss. A normal conversation registers at about 60 decibels. Prolonged exposure to decibel levels over 75 can damage hearing, and regular exposure of more than one minute to levels above 110 decibels can cause permanent hearing loss.

• A physical exam to find the cause of hearing loss.
• Avoiding loud noises that can further damage hearing.
• A hearing aid to amplify sounds.
• Medications to treat any ailments that may be impairing your hearing.

• Get a medical exam before you buy a hearing aid. In most provinces you'll need a written evaluation from your doctor to buy a hearing aid. Having test results to take to a hearing aid dealer makes it much more likely that you'll get the hearing aid that’s right for you.
• Make hearing loss prevention your job. An estimated three million Canadian workers are exposed to dangerous noise levels on the job. If you work around loud noises, wear earplugs or earmuffs. The Canadian Centre for Occupational Health and Safety (CCOHS) has compiled detailed information on maximum exposure levels to workplace noise across Canada. Contact the CCOHS at 1-800-668-4284 or www.ccohs.ca.

The Canadian Hard of Hearing Association has detailed information on hearing loss, support groups, resources and the latest on cochlear implants.

• Contact the association at 613-526-1584 (voice), 613-526-2692 (TTY) or online at www.chha.ca.

Hearing loss seems to be inevitable with age, but that doesn't mean you can't control it. Keep this guide in mind and be sure to visit your doctor for more treatment options.