Cognition clinic and memory clinic of a public hospital in Hong Kong. Statistical analysis was performed using receiver operating characteristic curve and regression analyses. A score of less than 22 should prompt further diagnostic assessment.
The ISO standard shows expected threshold changes due purely to age for carefully screened populations i. The effects of age can be exacerbated by exposure to environmental noisewhether at work or in leisure time shooting, music, etc. This is noise-induced hearing loss NIHL and is distinct from presbycusis.
A second Models of assessment for elderly factor is exposure to ototoxic drugs and chemicals. Over time, the detection of high-pitched sounds becomes more difficult, and speech perception is affected, particularly of sibilants and fricatives.
Patients typically express a decreased ability to understand speech. Both ears tend to be affected. The impact of presbycusis on communication depends on both the severity of the condition and the communication partner.
These factors are superimposed on a genetic substrate, and may be overshadowed by general age-related susceptibility to diseases and disorders. Hearing loss is only weakly correlated with age.
In preindustrial and non-industrial societies, persons retain their hearing into old age. Within family groups, heredity factors were dominant; across family groups, other, presumably sociocusis and nosocusis factors were dominant.
Oxidative stress Sociocusis[ edit ] Sociocusis is the condition of those who have hearing loss attributed to continuous noise exposures, unrelated to their job or occupation.
This exposure to these stimuli is frequent, and are often considered common "background noises" that affect the hearing abilities of individuals. Examples of sociocusis-related stimuli are the continuous noises from traffic, home appliances, music, television, and radio.
The accumulated exposure to these noises over many years can lead to a condition similar to pure presbycusis.
Nosocusis[ edit ] Nosocusis factors are those that can cause hearing loss, which are not noise-based and separate from pure presbycusis. Ingestion of ototoxic drugs like aspirin may hasten the process of presbycusis. May diminish vascularity of the cochlea, thereby reducing its oxygen supply.
Increased intake of saturated fat may accelerate atherosclerotic changes in old age. Is postulated to accentuate atherosclerotic changes in blood vessels aggravating presbycusis. May cause vasculitis and endothelial proliferation in the blood vessels of the cochlea, thereby reducing its blood supply.
However, a recent study found that diabetes, atherosclerosis and hypertension had no correlation to presbycusis, suggesting that these are nosocusis acquired hearing loss factors, not intrinsic factors. There are four pathological phenotypes of presbycusis: Located within the scala media, it contains hair cells with stereocilia, which extend to the tectorial membrane.
The organ's outer hair cells play a significant role in the amplification of sound and is extremely sensitive to external and internal factors.
If the outer hair cells are damaged, they do not regenerate. This results in a loss of sensitivity of hearing, as well as an abnormal perceived loudness in the aspect of the tonotopic spectrum that the damaged cells serve.
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Located in the lateral wall of the cochlea, the stria vascularis contains sodium-potassium-ATPase pumps that are responsible for producing the endolymph resting potential. As individuals age, a loss of capillaries leads to the endolympatic potential becoming harder to maintain, which brings a decrease in cochlear potential.
This type of pathology has not been verified as contributing to presbycusis. In addition there are two other types: Mixed Indeterminate The shape of the audiogram categorizes abrupt high-frequency loss sensory phenotype or flat loss strial phenotype.This work focuses on the living experience of elderly and disabled people who represent groups of population at risk of marginalisation: they are likely considered to be unable to take part in the so called active life which generally shapes the construction of identity in adulthood.
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Learn how UpToDate can help you. Select the option that best describes you. Medical Professional Several different models for CGA have been implemented in various health care settings. et al. Use of a Comprehensive Geriatric Assessment for the Management of Elderly Patients With Advanced Non-Small-Cell Lung Cancer: The Phase III.
From The Hartford Institute for Geriatric Nursing, New York University, College of Nursing Best Practices in Nursing Care to Older Adults general assessment series.