Age-Related Hearing Loss (Presbycusis)

Overview

Age-related hearing loss (presbycusis) is the decline in hearing that many people experience as they grow older.

Age-related hearing loss is most likely to occur after the age of 65.

Almost 1 in 3 adults experience hearing loss between the ages of 65 and 74. After age 75, about half of all adults have trouble hearing.

Symptoms and Causes

Most obviously, the primary symptom of age-related hearing loss is difficulty hearing. Hearing loss symptoms may also present as:

  • Difficulty making out higher pitches, such as children’s voices or some electronic sounds (like tones on a cellphone).
  • Reading lips when others speak to you.
  • Turning the volume up on the TV or radio.
  • Trouble understanding speech in crowded or noisy places, such as restaurants.
  • Tinnitus (ringing, buzzing, roaring noises or “crickets”) in one or both ears.

Most commonly, presbycusis (age-related hearing loss) comes from changes in the inner ear that occur as you age. It typically affects both ears equally and has a gradual onset. Many people have a combination of age-related hearing loss and noise-induced hearing loss. Over time, loud noises can damage your sensory hair cells, one of the parts of your ear that allows hearing.

Causes of hearing loss can vary. You are more likely to experience age-related hearing loss if you have:

Diagnosis and Tests

A hearing loss diagnosis begins by looking inside your ear. Your healthcare provider uses a tool called an otoscope (small magnifying instrument with a light) to look at your eardrum and outer ear canal. This exam checks for eardrum damage, inflammation (redness and swelling) or infection.

Your healthcare provider may refer you to an audiologist (hearing specialist) or otolaryngologist (ear, nose and throat specialist). During the test, your audiologist will have you listen to a series of beeps through a set of headphones and respond when you hear each sound. You will also listen for words presented at various loudness levels and repeat them back. The audiologist will use an audiogram to graph your hearing sensitivity, which can help give the provider clues about the type, degree and cause of your hearing loss.

Management and Treatment

Treatment for hearing impairment depends on the severity of your symptoms. Your healthcare provider may recommend:

  • Assistive listening devices: These tools might include cell phone amplifying devices, smartphone apps or closed-circuit systems in auditoriums or places of worship.
  • Hearing aids: A hearing aid is the most common treatment for age-related hearing loss. Hearing aids make noises louder. They have adjustable volume settings.
  • Cochlear implants: Cochlear implants can help some types of severe hearing loss. These small electronic devices stimulate the auditory nerve (nerve that enables you to hear). Your healthcare provider places cochlear implants through surgery.

Prevention

Experts don’t know how to prevent age-related hearing loss. You can reduce your risk of losing hearing as you get older by protecting yourself from noise-induced hearing loss.

You can minimize noise-induced hearing loss by:

  • Avoiding loud environments, such as concerts or sports stadiums.
  • Managing health conditions like diabetes and hypertension (high blood pressure).
  • Turning the volume down on the radio and TV.

Using hearing protection such as earplugs or earmuffs when you can't avoid loud sounds.

Outlook / Prognosis

Age-related hearing loss is a progressive condition, meaning it gets worse over time. But you can manage hearing loss with hearing aids or other treatments. Most people with age-related hearing loss can manage their condition and continue to live a full and active life.

Living With

You may ask your family or other loved ones to help you make it easier to live with hearing loss. Sharing about your hearing loss with others can help you find support to cope with the condition.

You can better manage your hearing loss by:

  • Informing friends, family and communication partners of your hearing loss.
  • Asking family and friends to face you when they speak.
  • Being specific when you’re telling someone how they can help you better understand. For example, let them know that they need to get your attention before they start talking or that you use facial cues to help you understand, so you need them to look at you when speaking.
  • Avoiding places with lots of ambient noise, such as restaurants or venues with live music.
  • Turning off the television or radio when you aren’t listening to them.
  • Wearing hearing aids or using other devices as directed by your provider.
  • Showing appreciation for when someone goes out of their way to help you.

A note from Cleveland Clinic

Age-related hearing loss is a typical part of aging. Many people experience a combination of age-related and noise-induced hearing loss. You can’t prevent age-related hearing loss. You can reduce your chances of experiencing noise-induced hearing loss by limiting prolonged exposure to loud noises. Treatment options may include assistive listening devices, hearing aids or implants. While hearing loss is normal as you get older, getting the right treatment can help you live a high quality of life.

Last reviewed by a Cleveland Clinic medical professional on 06/07/2021.

References

  • Centers for Disease Control and Prevention. Accessed 6/7/2021. How Do I Prevent Hearing Loss from Loud Noise? (https://www.cdc.gov/nceh/hearing_loss/how_do_i_prevent_hearing_loss.html)
  • National Institute of Deafness and Other Communication Disorders. Accessed 6/7/2021.Age-Related Hearing Loss. (https://www.nidcd.nih.gov/health/age-related-hearing-loss)
  • National Institute on Aging. Accessed 6/7/2021.Hearing Loss: A Common Problem for Older Adults. (https://www.nia.nih.gov/health/hearing-loss-common-problem-older-adults)

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