Presbycusis (Age-Related Hearing Loss)

What is presbycusis (age-related hearing loss)?

Presbycusis (prez-buh-KYOO-sis) is hearing loss that develops gradually as you get older. It’s the most common cause of hearing loss worldwide and affects 2 out of 3 people in the U.S. age 70 or older. The medical term comes from the Greek words for elderly (presby-) and hearing (akousis). Right now, there’s no cure for age-related hearing loss, but using hearing aids may help to improve hearing.

What are symptoms of presbycusis?

The most obvious symptom is not being able to hear as well as you used to. Presbycusis symptoms develop gradually. You may be developing age-related hearing loss if you:

• Can’t hear certain high-pitched sounds like birds singing or alarms.
• Always need to increase the volume on your cell phone, television, computer or tablet.
• Have tinnitus.
• Have trouble understanding what people are saying when you’re in a crowded room or a noisy place like a restaurant.

What causes presbycusis?

Presbycusis is a type of sensorineural hearing loss, or hearing loss that happens when something damages your inner ear. Risk factors for presbycusis include:

• A family history of hearing loss: Age-related hearing loss can run in families. If some of your family members developed hearing loss as they grew older, chances are you’ll have the condition, as well.
• Ototoxicity: This is inner ear damage that may be a side effect of certain medications.
• Noise exposure: Research shows people with noise-induced hearing loss often develop more severe age-related hearing loss.

Research suggests there’s a relationship between some medical conditions and age-related hearing loss, including:

• Coronary artery disease (CAD).
• Diabetes.
• Hypertension (high blood .
• Stroke.

What are complications of this condition?

Presbycusis does more than take away your ability to hear. If you have trouble hearing, you may feel anxious about talking to others because you strain to understand what they’re saying. Research shows having presbycusis increases your risk of developing:

• Social isolation.
• Mental health issues like anxiety disorder or depression.

How is presbycusis diagnosed?

Diagnosis may include:

• Physical examination by a primary care provider. They’ll examine your ears for signs of eardrum damage, inflammation, swelling or an infection. They may use an otoscope to examine your ears. Otoscopes are small magnifying instruments with lights that let providers look at your eardrum and outer ear canal.
• Hearing tests done by an audiologist. The pure tone test is a common test to diagnose presbycusis. This test finds the quietest volume you can hear at each pitch. You’ll wear headphones or earplugs to hear the sounds and speech.

Types of presbycusis

Your audiologist’s diagnosis may include details about the type of presbycusis that you have. The type you have depends on specific damage to your inner ear. To understand presbycusis types, it may help to know more about your inner ear structure and how hearing works:

1. Your inner ear contains your cochlea. It contains many tiny hair cells (stereocilia).
2. When sound vibrations from your middle ear reach these cells, they send a signal (electrical impulse) to your auditory nerve. This nerve connects your ears to your brain.
3. Your auditory nerve transmits the signal from your stereocilia to your brain, which receives the signals and translates them into sound.

The types of presbycusis include:

• Sensory presbycusis: This hearing loss happens when you lose outer hair cells in the organ of Corti at the base of your cochlea.
• Neural presbycusis: Your ability to hear relies in part on nerve cells in your cochlea and the auditory pathway to your brain. You lose nerve cells over time as part of growing older.

How is presbycusis treated?

The most common presbycusis treatment is to use hearing aids. Hearing aids amplify sounds and deliver them to your ear. However, hearing aids can’t cure presbycusis or restore lost hearing.

Does presbycusis type affect treatment?

No, the treatment is the same for all types of presbycusis. But diagnosing presbycusis type is one way your provider can predict the impact that age-related hearing loss will have on your life. For example, neural presbycusis affects your ability to understand what people are saying (speech discrimination).

What can I expect if I have presbycusis?

Presbycusis is a progressive condition, meaning it gets worse over time. But you can manage hearing loss with hearing aids. Most people with age-related hearing loss can manage their condition.

Can presbycusis be prevented?

Presbycusis is a common kind of hearing loss that happens as you age. You can’t prevent it, but there are things you can do that may slow down hearing loss or reduce your risk of developing severe presbycusis:

• Wear earplugs or other ear protection in situations or places where there will be loud sounds, like at a concert or a construction site.
• Turn down the volume of your television or music, particularly if you use headphones to listen to music, watch movies or listen to audiobooks.
• Move away from loud noise if you can’t protect yourself from it. For example, if you’re at a concert but don’t have earplugs, move away from the speakers.
• Stop smoking. Smoking can affect your circulation and your hearing, including increasing the chance you’ll have age-related hearing loss at an earlier age than usual. Talk to your provider about helpful resources for quitting smoking.
• Take care of your overall health. Experts think there may be a link between hearing loss, including presbycusis, and conditions like high blood pressure, stroke, diabetes and coronary artery disease. Reducing your risk for these conditions may help slow hearing loss.

How do I take care of myself?

Hearing aids will help you to hear better, but your hearing won’t come back. Living with hearing loss can be challenging even if you’re using hearing aids. Here are some suggestions for managing presbycusis:

• Share your situation: Tell family, friends and colleagues that you have hearing loss. They’ll want to know how they can help, like being sure to face you when they speak.
• Protect your hearing: Loud noise can make presbycusis worse. Remember to wear ear protection anytime you’re going to be around loud noise, whether that’s at work or attending events like concerts.
• Wear your hearing aids: Sometimes, people stop using hearing aids because the devices make their ears hurt. If you have presbycusis, wearing your hearing aids every day may slow down presbycusis. Talk to your audiologist if wearing your hearing aids is uncomfortable. They’ll be glad to adjust them.

When should I see my audiologist?

You’ll probably need annual checkups so your audiologist can do hearing tests to see if your hearing loss is getting worse. Contact your audiologist if you notice you’re having issues hearing even when you wear your hearing aids.

What questions should I ask my healthcare provider?

If hearing tests show you have presbycusis, asking the following questions may help you understand how hearing loss may affect you:

• How severe is my hearing loss?
• What treatment do you recommend?