The Paradox of Presbycusis

Added to the list of items accompanying the inevitability of death and taxes, we all begin to lose our hearing at some point.  Some of you, or your best friends have hearing aids, and none of us relish reaching that stage of life.  Presbycusis is the sensory analog of presbyopia, that 40-something and beyond stage of life when adults begin to lose visual focusing power.


I have written about the parallels between visual and auditory processing, but experiencing presbycusis firsthand is an ear-opener.  The paradoxes that come along with the first forays into sensorineural hearing or mechanical hearing loss are numerous.  Principal among them is the concept of “recruitment“, the fact that as you begin to lose segments of hearing, your auditory pathways find a way to recruit healthy residual segments, boosting their sound to compensates for what you’ve lost.  Recruitment comes with paradoxical costs, which means that you’ll find it more difficult to tune out sounds that don’t seem to present any bother to others around you.  Take for example these women having a conversation at Starbucks standing a fair distance away from me as I’m typing this, which seemed inordinately loud to me:

I can distinctly recall when I was in college spending a weekend at my aunt and uncle’s home in Brooklyn.  My uncle would repeatedly plead with my aunt: “Mummy, please speak up.  I can’t hear you!”  Oddly, when I or anyone else present that weekend spoke to him from the same distance, he seemed to have no trouble hearing us. I thought he might have just been giving her a hard time, though as I became more familiar with cognitive factors in hearing I realized it wasn’t volitional on his part.  The tendency is for spouses literally and unwittingly to tune each other out over time, and it has a scientific basis.

But remember, although there may be cognitive factors that influence auditory processing, that doesn’t necessarily extend to nonverbal communication.

Hearing Cartoon


About Leonard J. Press, O.D., FAAO, FCOVD

Developmental Optometry is my passion as well as occupation. Blogging allows me to share thoughts in a unique visual style.
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