Written by Dr. Kalene Gutman, Au.D., CCC-A
As an audiologist, the most common complaint I hear is difficulty understanding; my patients tell me, “I can hear people talking, but it’s not always clear”. This phenomenon can worsen as we age. It is caused by age-related changes in the body. Overuse of the inner ear over our lifetimes is age-related hearing loss; termed presbycusis. Presbycusis causes the components in the inner ear to wear out, causing high-pitched hearing loss and distortion.
The way I explain it to my patients is like this: “The low pitch range is where our vowel sounds are, that’s what gives our voices volume. The high pitch range is where our consonant sounds are, that’s what makes our voices and words sound clear”. Therefore, if people have better hearing in the low pitch range and have a hearing loss in the high-pitch range, they will often tell me “I can hear you, but I can’t always understand you.” That’s a tell-tale sign of presbycusis.
"The way our brain processes sound, as well as our cognitive abilities definitely play a role in our understanding. Older adults can have more difficulty with the subtle nuances of speech."

The way our brain processes sound, as well as our cognitive abilities definitely play a role in our understanding. Older adults can have more difficulty with the subtle nuances of speech. This can make listening to “fast-talkers” and people with accents more difficult. Listening involves very complex skills including focus and attention while blocking out distractions and transitioning attention between talkers. We have to fill in gaps of what we miss in order to successfully understand. This can become more challenging as we age.
These changes are happening over time because our bodies begin to wear out. However, there is something we can do about it. Treatment is recommended as soon as any difficulties arrive in order to slow the trajectory of age-related changes. Talk to your health care provider to get your hearing tested. With the proper treatment and intervention techniques your cognition can remain youthful.
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