Presbycusis (Age-Related Hearing Loss)

Presbycusis (prez-buh-KYOO-sis) is hearing loss that develops gradually as you get older. It’s a type of sensorineural hearing loss, or hearing loss related to damage in your inner ear. Age-related changes are the most common cause of hearing loss worldwide, affecting 2 out of 3 people in the U.S. age 70 or older.

There’s no cure for age-related hearing loss, but using hearing aids may help to improve your hearing.

Types of this condition

The type of presbycusis you have depends on the specific damage to your inner ear. Types include:

• Sensory presbycusis: This hearing loss happens when you lose outer hair cells in the organ of Corti. This structure is located at the base of your cochlea within your inner ear.
• Neural presbycusis: With this type, you lose nerve cells in your cochlea and/or the auditory pathway to your brain that helps you hear. Neural presbycusis affects your ability to understand what people are saying (speech discrimination).

Diagnosing presbycusis type is one way your provider can predict the impact that age-related hearing loss will have on your life.

Symptoms of presbycusis

The most obvious symptom is not being able to hear as well as you used to. Presbycusis symptoms happen over time. You may be developing it if you:

• Need to increase the volume on your cell phone, television, computer or tablet
• Can’t hear certain high-pitched sounds, like birds singing or alarms
• Have tinnitus
• Have trouble understanding what people are saying when you’re in noisy places, like crowded rooms or restaurants

Presbycusis causes

Presbycusis 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, you likely will, too.
• Noise exposure: People with noise-induced hearing loss often develop more severe age-related hearing loss.
• Ototoxicity: This is inner ear damage that may be a side effect of certain medications.

Experts think there may be a link between hearing loss and conditions like:

• Coronary artery disease (CAD)
• Diabetes
• High blood pressure
• Stroke

How to lower your risk

You can’t prevent age-related hearing loss, but there are things you can do that may slow the process or reduce your risk of developing severe presbycusis:

• Wear earplugs or other ear protection in places where there will be loud sounds, like at a concert or a construction site.
• 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.
• Turn down the volume of your television and devices you use to listen to music or audiobooks. This is especially important if you use headphones to listen.
• Stop smoking. Smoking can affect your circulation and your hearing. It can increase the chance you’ll have age-related hearing loss at an earlier age than usual. Talk to your provider about resources for quitting smoking.
• Take care of your overall health. Reducing your risk for conditions linked to presbycusis may help slow hearing loss.

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. This can lead to social isolation.

Research shows having presbycusis increases your risk of developing mental health issues like anxiety disorder or depression.

How doctors diagnose this condition

Diagnosis may include:

• Physical exam by a primary care provider: They’ll check your ears for signs of eardrum damage, inflammation, swelling or an infection. They may use a small magnifying instrument with lights, called an otoscope, to examine 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.

How is presbycusis treated?

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

The treatment is the same for all types of presbycusis.

When should I see my healthcare provider?

Your primary care provider may recommend you see an audiologist. Once you’re diagnosed, you’ll probably need annual checkups with your audiologist. During these visits, they 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 can I expect if I have presbycusis?

Presbycusis is a progressive condition, meaning it gets worse over time. But most people with age-related hearing loss can manage it with hearing aids. If you have presbycusis, wearing your hearing aids every day may slow its progression.

Is there anything I can do to feel better?

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.
• Wear your hearing aids: Sometimes, people stop using hearing aids because the devices make their ears hurt. Talk to your audiologist if wearing your hearing aids is uncomfortable. They’ll be glad to adjust them.