The main symptom of bilateral hearing loss-and not just in old age-is a progressive communication disorder caused by a reduced ability to discriminate speech ( 3). The hearing-impaired patient attempts to compensate for the untreated presbycusis by associative mechanisms and by avoiding difficult hearing situations. Age and hearing loss may possibly be indirectly associated in time, but there is no immediate causal connection ( 8). A distinction must be maintained between presbycusis and other diseases leading to hearing loss that can appear at any age including old age compared to presbycusis, these are responsible for only a small part of all hearing loss in older patients. In total, 20 to 30 million adults in Germany are reported to have a hearing impairment ( 6). One recent study of certain parts of Germany reports that, in total, 16.2% of all adults are hearing-impaired and 6.5% of all adults use hearing aids ( 7). Data on the prevalence of impaired hearing and the use of hearing aids in Europe and in Germany are incomplete, partly because of variations in the definition of what constitutes a significant level of hearing loss ( 5, 6). Among over-60s, more than 20% of those surveyed had trouble with their hearing, and among over-70s the figure was more than 30% ( 4). About one-third of those affected are aged 65 or over. Progressive sensorineural hearing loss in old age, usually bilateral, is referred to as presbycusis ( 3). Hearing disorders are most common in old age. According to World Health Organization criteria, it is one of the most common health deficits in human beings ( 1), with 450 million people affected worldwide ( 2).
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