Neurobiological aspects of hearing deprivation and its impact on quality of life in old age

Age-related changes in the body can cause functional limitations that make it difficult for older people to maintain their lifestyle and fulfil their social and personal roles, affecting their ability to live a full life. This article explored the main mechanisms by which hearing loss affects the quality of life in older people. Scientific publications from 2016-2025 in the MEDLINE/PubMed biomedical research database were reviewed. The analysis showed that age-related hearing loss is primarily caused by neurodegenerative processes. It was found that the degeneration of neurons in the auditory pathway – from the hair cells of the cochlea to the neurons of the neocortex – occurs in a reduction in the cell population, morphological alteration of neurons, and a decrease in the number of synaptic contacts. These changes are accompanied by disturbances in biochemical and electrophysiological homeostasis, dysregulation of intracellular calcium signalling, and decreased levels of key neurotransmitters, including glutamate, glycine, and γ-aminobutyric acid. Further analysis showed that these neurobiological disorders lead to a decrease in impulse activity and a weakening of inhibitory processes, which clinically manifests itself in auditory dysfunction, impaired perception of acoustic signals, and a decrease in the ability to spatially localise sound. The study determined that concomitant microangiopathy is characterised by inhibition of angiogenesis, decreased density of functioning capillaries, thickening of the basement membrane, and endothelial dysfunction, which leads to decreased tissue perfusion. It was found that microcirculatory insufficiency contributes to secondary ischaemic cell damage through the activation of oxidative stress and inflammatory cascades. Generalised age-related degeneration of neurons and microvessels is also evident in the brain structures responsible for cognitive functions. As a result, a recurrent pathophysiological mechanism is formed: auditory deprivation increases cognitive load and accelerates the depletion of neural resources, which in turn exacerbates neurodegenerative processes and structural changes in the brain. Analysis has shown that these processes mutually potentiate each other, causing progressive deterioration of cognitive functions and a decrease in physical and social activity in older people