Ask the Doctors

Dear Doctor: My parents, who are in their late 70s, are both now using hearing aids. This makes me wonder -- when should a hearing test become part of an annual checkup?

Dear Reader: Our ears connect us to the world, and yet until something goes wrong, hearing is one of the senses we seem to take for granted.

It's a good idea to have a hearing test as a baseline when you're a relatively young adult so that if you develop a hearing issue later, you will have a useful comparison. You can talk to your family doctor about giving you a hearing test or seek out the help of a hearing professional, known as an audiologist.

Hearing loss usually happens so gradually that you may not even be aware of it. It's not until you run into problems such as frequently asking people to repeat themselves or cranking up the volume on your TV that you realize something has changed.

Hearing is a complex process. When you hear a sound, your brain is interpreting electrical signals that it receives via the auditory nerve. These signals originate in the delicate structures within your inner ear, which receive sounds -- that is, vibrations -- and turn them into nerve impulses.

It's important to identify hearing loss as soon as possible. Studies suggest a link between hearing loss and serious conditions such as depression or dementia. An early diagnosis and successful intervention can reduce symptoms of depression and help preserve cognitive function.

If you think you may have trouble with your hearing, you're not alone. About 15 percent of American adults report some form of hearing problem. Signs that you could be experiencing hearing loss may include:

-- Frequently asking people to repeat themselves;

-- Having trouble pinpointing the source or direction of a loud noise;

-- Trouble hearing telephone conversations;

-- Being told the volume of your TV or radio is excessively loud;

-- Difficulty understanding a person who isn't facing you as he speaks;

-- Struggling to hear conversations in noisy environments, like a restaurant;

-- Difficulty understanding high-pitched voices;

-- Being told by others that your hearing seems impaired.

If you've experienced these situations, a hearing test is a good idea. It will reveal whether you have hearing loss in either ear, and pinpoint the type of hearing loss and to what degree it has progressed.

There are several types of hearing tests.

A physical exam with an instrument called an otoscope reveals any problems in your ear canal or eardrum. Additional tests include a pure tone test, which reveals how well you can hear -- you guessed it -- a variety of pure tones.

A speech test evaluates your ability to understand the spoken word. Tympanometry tests reveal any problems in the middle ear and evaluate the mobility of your eardrum.

These hearing tests are painless. Taken together, the results offer a detailed picture of your hearing, known as an audiogram. And if a problem should be uncovered, your audiogram gives you and your doctor the information needed to move forward.

(Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health.)

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095.)

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