Age-Related Diseases

1 Hearing & Eye Age-Related Diseases Introduction Presbycusis is a physiological hearing loss associated with aging. Hearing loss develops gradually over time and becomes more apparent from the age of 60. This varies between individuals as there are stressors that can potentially speed the rate of hearing deterioration. The common signs and symptoms associated with presbycusis include tinnitus, inability to decode high-pitched sounds, mumbled speech, troubled conversations especially with background noises, need to ask someone to speak loudly or turn up the volume of the radio or television and withdrawing from conversations, among others (Tawfik et al., 2020).

Etiology Age-induced degeneration is the main cause of presbycusis. It results in physiologic and anatomic changes within the ear, which eventually affects the hearing function. Aging impacts several parts of the ear causing loss of receptor hair cells, degeneration of stria vascularis, changes of the cochlear duct and loss of cochlear nerve fibers. These changes can occur singularly causing a specific type of presbycusis or mixed presbycusis in cases where the above changes occur concurrently (Fischer et al., 2016).

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2 Other than aging, factors such as genetics, exposure to loud noise, certain medications and hormonal factors may also contribute to presbycusis.

Differential Diagnosis The differential diagnosis to consider in presbycusis includes cerumen impaction, tumor obstruction, perforation, and cholesteatoma. These conditions are to be suspected if hearing loss is consistent with problems of transferring sound waves within the outer and middle ear.

Sensorineural differential diagnosis to consider includes autoimmune disease, exposure to noise and ototoxic agents, metabolic dysfunction, tumor and perilymph fistula. In this case, the sensory organ of the ear is affected (Fischer et al., 2016). Audiometry testing, imaging and metabolic assessment should be considered when determining the correct diagnosis.

Interventions and Education Measures Presbycusis is irreversible and incurable but can be managed to slow down the progressive hearing loss and to improve hearing function. The interventions to be used depend on individual preference, their health state and age. This includes the use of hearing aids, implants and assistive devices that amplify sound or converts speech to text. Removing cerumen can also improve hearing (Tawfik et al., 2020).

Education is essential to enable the patient adapt to the condition and also prevent its worsening. This includes measures such as avoiding loud noises, maintaining clean ears, staying in quite areas, asking others to speak loudly and learning to utilize nonverbal cues in a conversation such as lip-reading.

Definition and Elaboration of Different Retinal and Macular Diseases Aging also affects the eye. Common age-related retinal and macular diseases include macular degeneration, glaucoma and cataracts (Young, 2015). Age related macular degeneration

3 (ARMD) affects the fovea, the central part of the retina. It occurs as a result of the deterioration of the macular, leading to the loss of central vision. Glaucoma is an eye condition that occurs as a result of an impaired flow of fluid within the eye. This results in abnormally high pressure in the eye which damages the optic nerve. It is associated with slow peripheral vision loss causing blind spots or tunnel vision. Cataracts cause a gradual decrease in vision due to opacification of the eye lens. It is characterized by cloudy, blurred or dim vision and diminished color of objects.

Cataracts can be successfully treated with cataract surgery, done by replacing lens with an artificial intraocular lens (Young, 2015).

4 References Fischer, N., Weber, B., & Riechelmann, H. (2016). Presbycusis-age related hearing loss. Laryngo-rhino-otologie, 95(7), 497-510.

Tawfik, K. O., Klepper, K., Saliba, J., & Friedman, R. A. (2020). Advances in understanding of presbycusis. Journal of neuroscience research, 98(9), 1685-1697.

Young, J. S. (2015). Age-Related Eye Diseases and Recommendations for Low-Vision Aids, Home Healthcare Now, Volume 33 - Issue 1 - p 10-17 doi: 10.1097/NHH.0000000000000177