Hearing impairment with advancing age is termed as Presbyacusis. It is generally caused by a reduction in the number of cochlear outer hair cells or auditory nerve fibres due to senile degeneration, which may be accelerated by noise and ototoxic medicines exposure. Usually it starts from the higher hearing frequencies which manifests as decreased speech discrimination and intelligibility and the patients complain to have heard the voice but not understood it and may ask it to be repeated again with more problems in a noisy enviorment.
An Audiogram (Pure Tone and Speech) is recommended to assess the pattern (high and /or low frequency), severity (loss in decibels) functional impairment (Speech Discrimination Score). At a loss of more than 35 to 40 Db a Hearing Aid is generally recommended.