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SENIORS MONTH - Why do older people complain about difficulty hearing conversations, especially in noisy situations?

Why do older people complain about difficulty hearing conversations, especially in noisy situations?

Usually starting in our 40s, we often begin to notice problems understanding speech, especially in background noise. These problems usually increase gradually over the years before a clinically significant hearing loss is identified (on an audiogram). However, people of any age have more difficulty focusing attention, understanding and remembering when they listen in noisy situations compared to quiet situations. But, because the amount of noise required to make listening difficult for an older adult is less than what it takes for younger adults, we become more aware of our difficulties as we age.

Most people think that problems understanding speech in everyday conversations are only about our ears. But the ears are the doorway to the brain. To follow a conversation, we use our ears to hear and we use our brain to focus attention on, understand and remember what is said.

When people try to follow and understand a group conversation, they need to process the words that they hear. Fast and efficient processing of information, as in a conversation in a noisy room, involves not only hearing, but also focusing attention, understanding and memory. Changes in the ear with age can make it more difficult to listen. In turn, difficulty hearing can reduce how efficient the brain can focus on, understand and remember the information that was heard.

What is important and what is ‘noise’?

Imagine yourself in a noisy restaurant with a friend. You may find it interesting to eavesdrop on what the person sitting next to you is saying. When you redirect your attention to what your friend is saying, the conversation occurring at the table next to you now becomes ‘noise’ you don’t want to hear. It is our brain that allows us to ignore ‘noise’ and pay attention to the sounds we want to hear. And, what we consider ‘noise’ depends on the situation and not simply which sounds are entering our ears.

As your friend is talking, your brain is working to interpret and understand what is said. If your friend starts talking in a foreign language, you will hear the sounds but they will be meaningless to you. But if your friend is saying something important to you, your ears and your brain work together so the information coming into our ears can be stored in memory for you to use it later.

What happens as we get older?

As we get older, there are changes in our ears and changes in our neural networks that connect our ears to the various parts of our brain. Some changes in our hearing and memory are part of normal aging. Hearing, focusing on and remembering information becomes progressively more difficult. However, older adults can use their experience and knowledge to their advantage. Improved ability to use context and knowledge of the world helps older adults to compensate. But, by using knowledge to compensate when it is difficult to follow conversation in noise, older adults may need to increase brain activity more than younger adults would need to do. As we get older, the continual mental effort required to listen can be stressful and reduce enjoyment of social gatherings. So, by solving hearing problems, you could make it easier to focus, understand and remember what you hear. Use hearing aids and take a load off your brain!