What Is Age Related Hearing Loss (Presbycusis)?

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Old woman with hearing loss getting fit for hearing aids

As we journey through life, aging is an inevitable process that brings about numerous transformations. Our bodies evolve continuously, with some changes being visibly apparent, such as the emergence of grey hair and wrinkles. However, many alterations occur at a deeper, cellular level, leading to various health issues, including Alzheimer’s and arthritis.

Our ears are no exception to this natural aging process. Just as grey hair is a common hallmark of aging, age-related hearing loss is a condition that many of us will experience. However, it’s important to approach this topic not with a sense of inevitability, but with an understanding that there are ways to manage and prepare for these changes.

This article delves into the realm of hearing health, exploring how age-related hearing changes can impact our lives and what steps we can take to mitigate gradual hearing loss. With the right knowledge and preparation, and by being mindful of risk factors such as exposure to loud noises, smoking, and ear infections, we can better navigate the challenges of hearing loss in our later years.

Signs And Symptoms Of Hearing Loss

Older man speaking with his doctor

Age-related hearing loss, or presbycusis, is more common than most people realize. It’s one of the most common age-related medical conditions, affecting 1 in 3 people between 65 and 74, and nearly half of adults over 75.

Common signs of hearing loss include:

  • Muffled hearing
  • Difficulty understanding speech, especially soft or distant speech
  • Difficulty hearing in the presence of background noise
  • Sudden or gradual loss of hearing
  • Aural fullness or “stuffy” sensation in one or both ears
  • Ringing in the ear or tinnitus

A hearing problem, whether age-related or not, typically presents with many of the same symptoms as listed above. Presbycusis is distinguished by a gradual hearing loss that affects both ears equally. This type of hearing loss can occur in conjunction with other causes of hearing loss such as noise-induced hearing loss, head/neck trauma, and ototoxic damage.

Everyday symptoms of age-related hearing loss also include:

  • Challenges in understanding or hearing higher-pitched voices distinctly.
  • A decreased tolerance for loud noises.
  • Experiencing tinnitus triggered by specific sounds.
  • A tendency to more easily distinguish male voices compared to female voices.
  • The need to watch TV or use speakerphones at higher volumes, often leading to complaints from others.
  • Difficulty in hearing high-pitched sounds, especially the voices of children and women.

Why Do We Lose Our Hearing As We Get Older?

Getting older means the complex system that allows us to hear sounds and understand speech will show signs of aging too. The natural aging process combined with hair cell damage within the inner ear, middle ear, and other parts of the auditory system affects the way our brains process sound. This results in trouble hearing.

Age-related hearing loss typically runs in familial lines, and patients are more likely to experience presbycusis if there’s a family history of hearing loss.

Other causes of hearing loss in older adults

Certain Medical Conditions

Lupus, diabetes, otosclerosis, and certain STDs have all been linked to hearing loss in older adults. Other health conditions and illnesses that can cause trouble hearing include jaundice, coronary heart disease, high blood pressure, and stroke. Head and neck trauma can also result in sudden sensorineural hearing loss.

Work-Related Noise Exposure

Construction worker grinding metal

Jobs that involve a lot of noise, such as construction, military, and dentistry have been known to increase the chances of developing hearing loss. Long-term exposure causes damage to tiny hair cells in the inner ear which can be irreversible, and result in permanent hearing loss. Sudden hearing loss can even result from one-time exposure to loud sounds like gunshots and explosions.


Ototoxic medications impact hearing in one or both ears, and include OTC medications like aspirin, certain antibiotics and chemotherapy drugs, and antimalarial drugs. In many cases, stopping these medications won’t reverse the damage, and will require diagnosis and treatment from a hearing specialist.

Severe Hearing Loss And Health Complications

Sometimes, hearing loss is more than just a hearing problem. In many instances, it coexists with other health conditions, or increases the risk of developing others. Patients with age-related hearing loss may also experience:

  • Balance issues: Hearing loss and balance issues have both been linked to abnormalities in the inner ear. This puts older adults with hearing issues at a higher risk of falling, and other balance-related functions.
  • Permanent hearing loss/deafness: A hearing problem can be a precursor to deafness. Managing hearing problems with a healthcare professional is the only way to minimize the impact on cognitive health, everyday life, and hearing health.
  • Depression and Anxiety: Age-related hearing loss can have a significant impact on the personal or social life of patients, due to a lack of ability to communicate or hear important information clearly. In some instances, patients may avoid social interactions, experience self-esteem issues, and have a lower quality of life.
  • Dementia: A recent hearing loss study of over 2400 participants demonstrated how patients with moderate hearing loss were three times more likely to develop dementia when compared to those with normal hearing. This risk increases with the severity of the hearing problem.

How Is Age-Related Hearing Loss Diagnosed?

Woman getting an audiological evaluation

If you’re constantly asking people to speak louder, or you have problems hearing high-pitched sounds like smoke alarms, seek advice from a health care professional. You’ll be referred to a hearing specialist such as an audiologist or otolaryngologist (ear, nose, throat physician). A medical exam will help to determine if there’s damage to the outer ear canal, too much wax, or another physical explanation.

Hearing tests are used to determine the type of hearing loss, whether sensorineural, conductive, or mixed. They also help to determine the severity of the hearing loss and find potential causes, whether age-related or otherwise.

Overcoming Hearing Aid Myths

Aging adults are already undergoing so many changes in their lives, and hearing loss and communication difficulties can often be the straw that breaks the camel’s back. Hearing loss can get put on the back burner while other, more pressing matters are dealt with. In fact, the average person waits 5 to 7 years before addressing their hearing loss or even doing a hearing test.

Waiting too long to face the issue will only worsen the situation, and making excuses will only serve to affect hearing and impact your mental health. Even though many people say that their hearing loss isn’t that bad, it’s always better to be proactive and address any issues immediately.

Others fall victim to hearing aid myths like “wearing hearing aids means I’m old” and “hearing aids are hard to use”, and ignore their decline in hearing sensitivity. A lot has changed concerning hearing aids, and they’re a lot more advanced than they were a few years ago. Advanced software detects environmental changes and adapts settings to the user’s preferences and audiologist specifications.

Modern hearing aids are smaller and are virtually invisible when compared to hearing aids of the past. They fit seamlessly in the canal or behind the ear, increase hearing limits, and help treat other hearing-related disorders like tinnitus.

Can Hearing Aids Help With Age-Related Hearing Loss?

Man getting fit for hearing aids via telehealth with Treble Health

Wearing a hearing aid isn’t a big deal, especially when they have the potential to significantly improve quality of life. Hearing aids are proven to reduce sadness and depression in patients who suffer from hearing loss, as they’re much more likely to participate in social activities regularly. In fact, this type of social engagement helps to keep the brain more youthful, delaying cognitive decline.

Hearing aids can also help to restore confidence and self-esteem in older adults when used in the early management of age-related hearing loss. One study revealed men have a higher risk of psychological distress as a result. However, early diagnosis and rehabilitation can have a life-changing impact on managing the condition.

How Is Age-Related Hearing Loss Treated?

While there is no cure for age-related hearing loss there are many treatment options available, all focused on improving your ability to facilitate better communication and improved quality of life.

The following are commonly used treatment options:

Hearing Aids

A hearing aid picks up sounds from the environment, amplifies them to an audible level, and reduces background noise for a better listening experience. An OTC hearing aid can be useful for treating mild hearing loss, however, more severe cases require prescription hearing aids.

Assistive Listening Devices

Assistive devices include any device, except hearing aids, which use sound amplification or visual or vibrotactile alerts to enable communication for people with hearing problems. Examples of assistive devices include amplified telephones, pocket talkers, flashing lights, doorbells, alarm clocks, and more.

Cochlear Implants

When hearing loss is not appropriate for hearing aids, these FDA-approved, surgically implantable devices provide electrical stimulation to the auditory nerve for correcting profound hearing loss.

Cognitive Behavioral Therapy

Traditional talk therapy can help a patient with age-related hearing loss manage the psychological side effects. It can also improve patient attitudes towards hearing aids and other hearing restorative devices.

What Can I Do To Prevent Age-Related Hearing Loss?

Unfortunately age-related hearing loss can’t be prevented, but like most things health-related, the better we treat our bodies, the longer they will last.

Man eating a salad

Eating a well-balanced, healthy diet, and exercising daily is a great place to start. This keeps the heart and circulatory system healthy, allowing it to provide the ear with oxygen-rich blood and the nutrients it requires to function on a day-to-day basis.

Avoiding ototoxic chemical exposures, loud noises, and physical trauma to the ears will also reduce the risk of further hearing loss. Earmuffs and noise-canceling headphones are a big help when you have no control over loud noise in your environment,

How Can My Friends And Family Help Me?

Having a great support system can go a long way. The following communication strategies are recommended when communicating with loved ones who have hearing loss:

  • Speak at a normal volume and speak slowly. It may be tempting to speak loudly to someone with hearing loss, but this can distort the words. Instead, focus on slowing down your speech. This gives the person some extra processing time, which can be very helpful!
  • Reduce extra background noise when trying to have a conversation. Having the TV or the washing machine going can make it harder to process sound.
  • Keep your mouth uncovered. Don’t talk with your hands in front of your mouth, while chewing or yawning as this makes it difficult for someone with hearing loss to hear you or even read your lips.
  • Stay close. Do not try to speak from another room or when your back is turned to the person. This is especially important when there are other competing sounds in the environment, like your TV.
  • Get their attention and pay attention. Before starting a conversation, say the person’s name so that you can get his or her attention. This will reduce the amount of times someone has to say “what?” due to inattention and not necessarily their hearing loss. They’ll also feel less embarrassed.
  • Be specific. If you are giving important information like dates/times/addresses, write the important information down as a supplement to your conversation so that you can make sure they got the specifics correct. Send a text later with all the details of the event to avoid awkward situations.
  • Don’t speak over each other. This is especially important in noisy social settings. Try speaking one at a time to help maximize the person’s ability to hear each person.
  • Repeat then Rephrase. If repeating the word or sentence does not help, try rephrasing it in another way. Just don’t be condescending, or sound annoyed.
  • Ask the listener what he or she needs you to do to facilitate better communication in the event of a breakdown and listen to their suggestions.

Living With Age-Related Hearing Loss

The prognosis for age-related hearing loss is often good. With proper identification and treatment, age-related hearing loss can be managed very well so that you may live a full and active life. Professional assistance in diagnosis and treatment, as well as support from your friends and family, may help prevent isolation and depression surrounding your hearing loss diagnosis.

If you experience sudden hearing loss, especially after exposure to loud noise or injury, see a professional right away. Uncorrected hearing loss can become permanent and lead to deafness.

Treating Hearing Loss With Treble Health

At Treble Health, our audiologists have helped hundreds of patients with hearing loss. Our approach is centered on understanding each individual’s unique hearing challenges and providing personalized care. Before starting with our team, we require a comprehensive hearing assessment to pinpoint the specific nature and extent of hearing loss. This enables us to tailor our treatment plans to each patient’s needs, whether it’s prescribing the most suitable hearing aids, or creating a comprehensive plan that involves other treatment methods as well.

We believe in empowering our patients with knowledge and tools to manage their hearing health effectively. This includes educating them about how to protect their hearing from further damage, such as avoiding prolonged exposure to loud noises, and offering advice on how to optimize their environment for better hearing. Our goal at Treble Health is not just to treat hearing loss, but to enhance the overall quality of life for our patients, ensuring they can communicate effectively and enjoy the sounds of life to the fullest.

If you want to learn more about how we can help with your particular case, we encourage you to schedule a complimentary telehealth consultation with our team.

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