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Age-Related Hearing Loss (Presbycusis)

What is presbycusis?

Age-related hearing loss (presbycusis) is the gradual loss of hearing in both ears. It’s a common problem linked to aging.  About 30% of adults over age 65 have hearing loss.

Because the hearing loss happens slowly, 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 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 and certain antibiotics

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. Always see your healthcare provider for a diagnosis.

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 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, and inflammation or infection.

You may be referred to a hearing specialist, called an 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 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?

Your healthcare provider will figure out the best treatment plan for you based on:

  • Your age, overall health, and medical history

  • How sick you are

  • How well you can handle certain medicines, treatments, or therapies

  • How long the condition is expected to last

  • Your opinion or preference

Frequently Asked Questions About Hearing Aids

Dr. Frank Lin speaking with a patient.

If you are considering a hearing aid, you are bound to have questions. Here are some answers, provided by Johns Hopkins experts. See common hearing aid questions and answers.

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

  • 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

Hearing Loss: Why Choose Johns Hopkins?

Man cupping his ear, struggling to hear.

Hearing problems don’t discriminate and can affect people at any stage of life. Don’t suffer in silence with hearing loss.

Our center’s physicians are among the finest and most highly skilled otologists and neurotologists (ear, nose and throat doctors) in the world. Their expertise, coupled with the care of licensed and certified audiologists, ensures you get quality care.

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 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.

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

Key points

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

  • It is a common problem that happens with aging. About 30% of adults over age 65 have hearing loss.

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

  • 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.

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