What is age-related hearing loss?

Age-related hearing loss (presbycusis) is the loss of hearing that gradually occurs in most of us as we grow older.  

Approximately one in three people (28.7 million) in the United States between the ages of 65 and 74 has hearing loss, and nearly half of those older than 75 have difficulty hearing. Having trouble hearing can make it hard to understand and follow a doctor's advice, respond to warnings, and hear phones, doorbells, and smoke alarms. Hearing loss can also make it hard to enjoy talking with family and friends, leading to feelings of isolation.

Age-related hearing loss most often occurs in both ears, affecting them equally. Because the loss is gradual, if you have age-related hearing loss you may not realize that you've lost some of your ability to hear.

There are many causes of age-related hearing loss. Most commonly, it arises from changes in the inner ear as we age, but it can also result from changes in the middle ear, or from complex changes along the nerve pathways from the ear to the brain. Certain medical conditions and medications may also play a role.

Why do we lose our hearing as we get older?

Many factors can contribute to hearing loss as you get older. It can be difficult to distinguish age-related hearing loss from hearing loss that can occur for other reasons, such as long-term exposure to noise.

Noise-induced hearing loss is caused by long-term exposure to sounds that are either too loud or last too long. This kind of noise exposure can damage the sensory hair cells in your ear that allow you to hear. Once these hair cells are damaged, they do not grow back and your ability to hear is diminished.

Conditions that are more common in older people, such as high blood pressure or diabetes, can contribute to hearing loss. Medications that are toxic to the sensory cells in your ears (for example, some chemotherapy drugs) can also cause hearing loss.

Most older people who experience hearing loss have a combination of both age-related hearing loss and noise-induced hearing loss.

Can I prevent age-related hearing loss?

At this time, scientists don't know how to prevent age-related hearing loss. However, you can protect yourself from noise-induced hearing loss by protecting your ears from sounds that are too loud and last too long. It's important to be aware of potential sources of damaging noises, such as loud music, firearms, snowmobiles, lawn mowers, and leaf blowers. Avoiding loud noises, reducing the amount of time you're exposed to loud noise, and protecting your ears with ear plugs or ear muffs are easy things you can do to protect your hearing and limit the amount of hearing you might lose as you get older.

How can I tell if I have a hearing problem?

Ask yourself the following questions. If you answer "yes" to three or more of these questions, you could have a hearing problem and may need to have your hearing checked.

What should I do if I have trouble hearing?

The most important thing you can do if you think you have a hearing problem is to seek advice from a health care provider. There are several types of professionals who can help you. You might want to start with your primary care physician, an otolaryngologist, an audiologist, or a hearing aid specialist. Each has a different type of training and expertise. Each can be an important part of your hearing health care.

• An otolaryngologist (oh-toe-lair-in-GAH-luh-jist) is a doctor who specializes in diagnosing and treating diseases of the ear, nose, throat, and neck. Sometimes called an ENT, she will try to find out why you're having trouble hearing and offer treatment options. She may also refer you to another hearing professional, an audiologist.
• An audiologist  has specialized training in identifying and measuring the type and degree of hearing loss. Some audiologists may be licensed to fit hearing aids.
• A hearing aid specialist is someone who is licensed by your state to conduct and evaluate basic hearing tests, offer counseling, and fit and test hearing aids.

*This is a partially reprinted with permission from the National Institute on Deafness and Other Communication Disorders. The full article can be accessed at https://www.nidcd.nih.gov/sites/default/files/Documents/health/hearing/AgeRelatedHearingLoss.pdf