Abstract
The hearing of advanced age was discussed on its various spheres: the pure tone audiogram, the speech audiogram, its changes after the lapse of three or four years, and the relationship between hearing and general senile changes.
1: Audiometric tests were done about 123 patients of age greater than 50, who complained of their tinnitus or hearing impairment, and as the control 131 persons of the same age living in a certain area of Fukuoka City were examined (Fig. 1 and 2).
Pure tone audiograms were divided into 6 types according to the classification by Kawata (Fig. 3), and the number of patients of each type were compared with that of the control group of the same type in 5th, 6th and 7th decades respectively.
In all the decades, the respective number of patients of both A (normal) and C (abrupt) types were smaller than that of the control groups of the same types. And concerning B (horizontal) and D (descendent) types the contrary relationship was observed. Generally speaking, those belonging to A and C types decreased, and those belonging to B and D types increased with the advancement of age, in both groups (Fig. 4-6).
2. 39 out of 69 patients of age greater than 60 complained of tinnitus. This percentage was similar to that of the report by Kirikae (1957).
3. Speech audiograms were divided into 5 types according to the classification by Tateishi (Fig. 7).
III Type was most frequently observed and I Type was observed as often as V Type (Fig. 8). The most of the patients who were examined soon after they noticed their hearing impairment turned to belong to I Type, and those who had noticed their hearing impairment long before they were examined proved to be involved either in III or V Type.
4. Audiometric tests were done again about 28 patients after three or four years. The changes of hearing loss in these tests were classified into three groups as follows:
Group 1. The changes of hearing loss were observed only in the range of high frequency. That is to say, A Type changed to C Type, or hearing loss in the range of high frequency of C Type advanced (Fig. 13 and 14).
Group 2. The changes of hearing loss were remarkable in the range of low frequency. Hearing loss in the range of low frequency of C Type advanced, that is, C Type turned to D Type, or the delivity of D Type decreased,
Group 3. The changes of hearing loss were observed in all the range of frequency (Fig. 17 and 18).
About 40% of this series belonged to Group 1, about 40% belonged to Group 2 and about 20% belonged to Group 3. The patients belonging to Group 2 were not conscious of their hearing impairment in the first examination but conscious of it in the second (Fig. 15 and 16).
In speech audiograms, I Type changed to either III or V Type. Figs 19 -21 show the changes in audiograms of several patients. The change from I Type to III or VType indicates the quantitative and qualitative change of hearing.
Consequently the author concluded that the changes of hearing in advanced age must be estimated not only in quantity but also in quality.
5. In order to investigate the relationship between hearing and general senile change, audiometric test and calculation of senile change index were done about 113 persons of age greater than 40 who entered hospital for medical examination.
Senile change index was calculated by the external appearance of hair, eye, teeth, skin, etc., and by the function of mind, eye, heart, liver, kidney, etc. The audiograms were classified by age (Fig. 22), and by senile change index (Fig. 23) respectively. It was thought rather reasonable to classify hearing loss paying regard not only to age but also to the senile changes of other parts of the body.
The author divided presbycusis into three types: physiological, general and local presbycuses taking into consideration both age and senile change index.
