Elderly patient with hearing rouble at doctor visit.
Elderly patient with hearing rouble at doctor visit.
Elderly patient with hearing rouble at doctor visit.

Age-Related Hearing Loss (Presbycusis)

What is presbycusis?

Age-related hearing loss (or presbycusis) is the gradual loss of hearing in both ears. It’s a common problem linked to aging. One in 3 adults over age 65 has hearing loss. Because of the gradual change in hearing, 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 beeping of a microwave. The ability to hear low-pitched noises is usually not affected.

What causes age-related hearing loss?

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

  • 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:

  • Continuous exposure to loud noise (such as music or work related noise)

  • Loss of hair cells (sensory receptors in the inner ear)

  • Inherited factors

  • Aging

  • Various health conditions, such as heart disease or diabetes

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

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What are the symptoms of age-related hearing loss?

The following are the most common symptoms of age-related hearing loss:

  • Speech of others sounds mumbled or slurred

  • High-pitched sounds, such as "s" or "th" are hard to distinguish

  • Conversations are difficult to understand, particularly when there is background noise

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

  • Some sounds seem overly loud and annoying

  • Tinnitus (ringing in the ears) may occur in one or both ears

The symptoms of age-related hearing loss may look like other conditions or medical problems. Always consult your health care provider for a diagnosis.

How is age-related hearing loss diagnosed?

Your health care provider will use an otoscope, which is a lighted scope, to check in the outer ear canal and to look at the ear drum. He or she will look for damage to the ear drum, blockage of the ear canal from foreign objects or impacted ear wax, inflammation or infection.

You may be referred to a hearing specialist, audiologist, to have an audiogram. An audiogram is a test in which sounds are played through headphones, to one ear at a time. You are asked to respond if you are able to hear each sound. If a person can’t hear certain tones this suggests there has been some degree of hearing loss.

How is age-related hearing loss treated?

Your health care provider will figure out the best treatment based on:

  • How old you are

  • Your overall health and medical history

  • How sick you are

  • How well you can handle specific medications, procedures, or therapies

  • How long the condition is expected to last

  • Your opinion or preference

Treatment options for age-related hearing loss may include the following:

  • Hearing aid(s)

  • Assistive devices, such as telephone amplifiers or technology that converts speech to text

  • Training in speech-reading (to use visual cues to determine what is being said)

  • Techniques for preventing excess wax in the outer ear

What are the 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.

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.

  • Avoid loud noises and reduce noise exposure

  • Wear ear plugs or special fluid-filled ear muffs (to prevent further damage to hearing)

Living with age-related hearing loss

If you have hearing loss, your health care 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.

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

Key points

  • Age-related hearing loss is a gradual hearing loss in both ears. It is a common problem associated with aging.

  • If you have sudden hearing loss, see your health care provider right away as this may be the development of a serious hearing problem.

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

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

Next steps

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

  • 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 names of new medicines, treatments, or tests, and any new instructions your provider gives you.

  • 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.

Age-Related Hearing Loss (Presbycusis)

Johns Hopkins Audiology

Our team of audiologists provides hearing testing, hearing aid selection and fitting, and implantable hearing devices for people of all ages. 

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