Age-Related Hearing Loss (Presbycusis)

What is presbycusis?

Age-related hearing loss (presbycusis) is the slow loss of hearing in both ears. It’s a common problem linked to aging. About 1 in 3 adults between the ages of 65 and 74 have hearing loss.

This hearing loss happens slowly. So some people are not aware of the change at first. Most often, it affects the ability to hear high-pitched noises, such as a phone ringing or a microwave beeping. The ability to hear low-pitched noises is often not affected.

What causes age-related hearing loss?

There may be many causes for age-related hearing loss. It most often occurs because of changes in the following areas:

• Within the inner ear (most common)

• Within the middle ear

• Along the nerve pathways to the brain

Other things that affect age-related hearing loss:

• Long-term exposure to loud noise (such as music or work-related noise)

• Loss of hair cells (sensory receptors in the inner ear) that help you to hear

• Inherited factors

• Aging

• Some health conditions, such as heart disease or diabetes

• Side effects of some medicines, such as aspirin, chemotherapy medicines, and certain antibiotics

• Being white

• Lower income level

• Infections

• Smoking

What are the symptoms of age-related hearing loss?

Each person’s symptoms may vary. Some of the most common symptoms include:

• Other people’s speech sounds mumbled or slurred

• Having trouble hearing high-pitched sounds

• Having trouble understanding conversations, often when there is background noise

• Men's voices are easier to hear than women's

• Some sounds seem very loud and annoying

• A ringing sound (tinnitus) in one or both ears

The symptoms of age-related hearing loss may seem like other health problems.

If sudden hearing loss occurs, it's important to contact your healthcare provider right away. Your provider will do a medical exam and a hearing exam as soon as possible to help find the cause and type of your sudden hearing loss. Based on your diagnosis, your provider will discuss possible treatments.

How is age-related hearing loss diagnosed?

Your healthcare provider will use a lighted scope (otoscope) to check in the outer ear canal and to look at the eardrum. They will look for damage to the eardrum, blockage of the ear canal from foreign objects or impacted earwax, and inflammation or infection.

You may be referred to a hearing specialist (audiologist) to have an audiogram. For this test, sounds are played through headphones, to one ear at a time. You are asked if you can hear each sound. If you can’t hear certain tones this may mean there has been some hearing loss.

How is age-related hearing loss treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment options for age-related hearing loss may include:

• Hearing aids

• Assistive devices, such as telephone amplifiers or technology that changes spoken words to text

• Training to use visual cues to figure out what is being said (speech reading)

• Methods to prevent too much wax in the outer ear

What are possible complications of age-related hearing loss?

If your hearing loss is significant enough, you may need some type of hearing aid or other aids to communicate with others.

Hearing loss in older adults can:

• Cause problems with receiving and understanding important information, such as financial, health, and legal information.

• Limit the person’s interaction with family, friends, and agencies. This can result in loneliness, isolation, and depression.

• Cause the person to avoid important meetings, such as medical follow-ups, because of embarrassment over the hearing problem.

• Pose a safety risk if the hearing loss is severe enough. For instance, if sounds, such as car horns or smoke alarms, can't be heard.

What can I do to prevent age-related hearing loss?

The most important way to prevent age-related hearing loss is to protect your hearing.

• Keep the volume of earbuds and headsets at a safe level

• Stay away from loud noises and reduce noise exposure

• Don't smoke

• Get timely care for health problems, such as ear infections

• Wear ear plugs or special fluid-filled earmuffs (to prevent more damage to hearing)

Living with age-related hearing loss

If you have hearing loss, your healthcare professional can refer you to specialists in hearing loss, such as an:

• Otolaryngologist. This is a doctor who specializes in diseases and conditions of the ears, nose, and throat. They are sometimes called an ENT.

• Audiologist. This is a healthcare professional who specializes in testing and managing hearing problems.

In addition to getting medical follow-up, you can also:

• Tell family and friends about the problem so they can help you cope.

• Ask people to face you when they talk so you can see their faces. Watching expressions and facial movements can help you understand the conversation better.

• Explain to people that they don't have to speak slowly or shout, just speak louder.

• Turn off the TV when you are not watching.

• Be aware of the impact of your environment on your hearing. In a restaurant, don’t sit next to a band or the kitchen. Background noise makes hearing more difficult.

Key points about age-related hearing loss

• Age-related hearing loss is the slow loss of hearing in both ears.

• It's a common problem that happens with aging. About 1 in 3 adults between the ages of 65 and 74 have hearing loss.

• The hearing loss happens slowly. So some people are not aware of the change at first.

• Staying away from constant or continuous exposure to loud noises can help protect your hearing and prevent gradual hearing loss.

• It's not a reversible condition so prevention is important.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your provider if you have questions.