Central Presbycusis: An Emerging View

Age-related dysfunction of the central auditory system (central presbycusis) is common but rarely looked for by those who provide aural rehabilitation. Patients who complain of difficulty hearing in noise—the key symptom of central presbycusis—are generally disadvantaged with conventional rehabilitation. This symptom should be documented with commercially available speech-in-noise tests, which use materials that are uncomplicated to administer. Those patients who perform poorly on such tests should have a customized rehabilitation program aimed at optimizing their remaining communication abilities. Otolaryngologists who provide auditory rehabilitation may wish to consider expanding their practices to meet the communication needs of older patients with central presbycusis. Central presbycusis is an emerging area for basic and clinical research in auditory neurotology, particularly in the relation of cognitive dysfunction to impaired auditory processing.