Understanding Age-Related Hearing Loss
Medically reviewed by John Carew, MD
When a person gets older, their ability to hear may gradually decrease over time. This process is referred to as age-related hearing loss. Age-related hearing loss, otherwise known as presbycusis, is common. Research shows that roughly one-third of people over the age of 65 will deal with some loss of hearing.
This article discusses the causes and symptoms of age-related hearing loss, as well as the diagnostic tools and treatment options available.
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What Is Age-Related Hearing Loss?
Hearing impairment affects many older adults. It is considered the most common issue affecting auditory perception, otherwise known as hearing.
When a person develops age-related hearing loss, their ability to hear is hindered. The hearing loss is gradual but progressive, so when it begins to deteriorate, hearing becomes more and more difficult over time.
What Causes Age-Related Hearing Loss?
There are various factors that can cause age-related hearing loss.
The main cause is the changes that occur in the inner ear and auditory nerve as a person ages. The inner ear is deep within the ear and is designed to help transfer the sounds that you hear to the brain with the help of the auditory nerve.
Other factors that can contribute to age-related hearing loss include:
Hearing loss that runs in your family
Exposure to extremely loud noise on a regular basis
Loss of hair cells in the ear that assist in the hearing process
Health conditions such as diabetes, heart disease, and high blood pressure
Head trauma
Ototoxic medications (such as NSAIDs or certain antibiotics) that cause permanent damage to the inner ear
What Is Affected by Age-Related Hearing Loss?
When a person develops age-related hearing loss, it happens bilaterally. This means that both ears are affected equally. The hearing develops gradually, but when it begins, it also continues to progress and worsen over time.
What Are the Symptoms of Age-Related Hearing Loss?
Hearing loss is more than just having difficulty hearing what a person is saying. There are several variations and symptoms that develop in someone who has age-related hearing loss. These include:
Hearing mumbled or slurred speech when people are speaking
Having issues with distinguishing sounds that are high in pitch
Being unable to have or understand a conversation unless there is complete silence in the background
Feeling as though some specific sounds are annoying and excessively louder than they should be
Ringing in the ears, known as tinnitus
Consequences of Age-Related Hearing Loss
A person dealing with age-related hearing loss and its symptoms is likely to experience mood changes that can lead to depression and anxiety. Being secluded from others because of hearing loss may contribute to these feelings of isolation. Age-related hearing loss has also been associated with an increased risk of cognitive decline and dementia.
How Is Age-Related Hearing Loss Diagnosed?
Early diagnosis is crucial. This is because non-age-related hearing loss is correlated with other disorders, and if it is diagnosed and subsequently treated earlier, some of those disorders may be prevented. Several different tests are used to identify hearing loss.
Upon initial examination, a healthcare provider will examine the ear with a special scope that has a light on it, otherwise known as an otoscope. They will check for any clear damage or blockages in the ear.
Further tests used to identify hearing loss include the Weber and Rinne, which both use a type of tuning fork. In the Weber test, the tuning fork is placed on top of the head, whereas the Rinne test uses a tuning fork placed behind the ear. The forks are then struck so they create a sound and the person being tested will relay when the sound has stopped.
Another type of test, which acts as a type of questionnaire, may be conducted in people over the age of 50. This type of test is known as the Mini Audio Test (MAT) and has people self-identify experiences they have with others based on their hearing abilities. A person is asked to fill out the form with questions as to whether they agree, partially agree, or disagree with the statement.
The statements on the MAT test include:
Other people tell me I have the television on too loud.
I don’t hear birds twittering or grasshoppers chirping very well.
I find it difficult to follow a conversation with another person in a moving train or bus.
I find it difficult to understand people when they whisper.
My difficulties with hearing lead to misunderstandings with people I am talking with.
Other people tell me that I have difficulty hearing.
Specialists for Treatment
You should first make an appointment with your primary healthcare provider to express your concerns about your hearing. They may refer you to an audiologist, who specializes in hearing health. Once it is clear that you suffer from at least some hearing loss, you may be referred to an otolaryngologist, which is an ear, nose, and throat specialist (ENT). They will perform any required examinations and provide you with a treatment plan.
Treatment Options for Age-Related Hearing Loss
The main treatment for age-related hearing loss is hearing aids. A hearing aid is an electronic medical device that is placed either in or around the ear to help improve someone's ability to hear sounds.
People will get one hearing aid per ear and the devices can improve hearing. People that wear hearing aids have to follow up with their otolaryngologist regularly to make sure that there are no issues with the hearing aid and their rehabilitation.
Hearing aids are also available over-the-counter for adults with self-perceived mild to moderate hearing loss.
Other possible treatment options include:
Devices that can amplify sounds
Devices that can translate speech into text so a person can read what a person is saying
Learning speech-reading techniques, such as sign language
Is Surgery an Option for Age-Related Hearing Loss?
In some rare cases, surgery may be performed if there are any injuries, inflammation, or disease within the ear. However, there are risks associated with surgery, so it is not considered a first-line treatment.
How Is Age-Related Hearing Prevented?
There is no true way to prevent-age related hearing loss, but there are ways you can protect your ears from other factors that may contribute to it.
This involves keeping your ears healthy and avoiding excessive noise exposure. If you have to be in areas with loud noises, wearing earplugs or earmuffs can help to limit the noise that makes its way into your ears.
Questions to Ask Your Provider
When suffering from hearing loss, you’ll want to make sure that you get the most out of your appointment with your healthcare provider. To do this, you can ask questions such as:
How quickly will my hearing worsen?
Will I lose my hearing completely?
What type of hearing loss do I have?
What part of my ear is affected?
Is the hearing loss the same in both ears?
How do I choose the right hearing aid for me?
Are hearing aids expensive, and is there any way to offset costs?
Do I need to replace my hearing aids regularly?
How often should I see my specialist about my hearing?
Summary
Age-related hearing loss is a type of gradual sensory loss that affects both ears as a person ages. The main cause of this type of hearing loss is age-driven changes to the inner ear and auditory nerve function. Other factors, such as existing health conditions and genetics, can also play a role in whether a person develops age-related hearing loss or not.
Hearing loss acts as an umbrella term for many symptoms that arise because of this type of age-related loss, such as speech that sounds mumbled or slurred when people are speaking to you, feeling overwhelmed by certain sounds, and experiencing ringing in the ears.
While there is no way to prevent age-related hearing loss, early diagnosis can aid in finding the right type of treatment. Typically, hearing aids are the first choice when it comes to age-related hearing loss. They are highly effective at restoring a person’s full sense of sound.
A Word From Verywell
Not being able to hear people when they’re talking to you can be a frustrating experience. This is especially true if it’s new. Fortunately, losing the ability to hear as you once did while you age is common. Effective treatments can help restore your ability to hear and ensure that you don’t miss out on engaging with friends, family, or others simply because you have gotten older.
Frequently Asked Questions
At what age should hearing screening take place in older adults?
Hearing screening tests should take place at any age if there is any indication that a person’s ability to hear isn’t what it should be. However, there is a typical age that people should begin screening so that any hearing loss is caught early. According to the U.S. Preventive Services Task Force recommendation statement, people should begin regular hearing screenings once they reach 50 years of age.
What are the three types of hearing loss?
The three types of hearing loss are sensorineural hearing loss, conductive hearing loss, and mixed hearing loss. Sensorineural hearing loss occurs when the inner ear and auditory nerve becomes damaged. Conductive hearing loss occurs when sound can’t get into the ear because of a blockage of some kind. Mixed hearing loss is a combination of both. Age-related hearing loss is a type of sensorineural hearing loss.
What are the common consequences of age-related hearing loss in an older adult patient?
Older adults who experience age-related hearing loss are often at an increased risk of cognitive decline and dementia. They may also develop late-onset depression or anxiety, which can be driven by feelings of social isolation or seclusion from their friends and family.
