As a person ages, their ability to hear can gradually decrease over time. This process is called age-related hearing loss. Age-related hearing loss, otherwise known as presbycusis, is common. Research shows that around a third of people over the age of 65 will experience hearing loss.
This article discusses the causes and symptoms of age-related hearing loss, as well as the diagnostic tools and treatment options available.
What is age-related hearing loss?
Hearing loss affects many older people. It is considered to be the most common problem affecting auditory perception, otherwise known as hearing.
When a person develops age-related hearing loss, their ability to hear is hampered. Hearing loss is gradual but progressive, so when it starts to deteriorate, hearing becomes increasingly difficult over time.
What causes age-related hearing loss?
Various factors can lead to age-related hearing loss.
The main cause is the changes that occur in the inner ear and auditory nerve as a person ages. The inner ear is located deep inside the ear and is designed to help transfer the sounds you hear to the brain using the auditory nerve.
Other factors that can contribute to age-related hearing loss include:
- Hearing loss that runs in your family
- Regular exposure to extremely loud noises
- Loss of hair cells in the ear that help in the hearing process
- Health issues such as diabetes, heart disease, and high blood pressure
- Head trauma
- Ototoxic drugs (such as NSAIDs or certain antibiotics) that cause permanent damage to the inner ear
What is affected by age-related hearing loss?
When a person develops age-related hearing loss, it happens bilaterally. This means that both ears are affected equally. Hearing develops gradually, but when it starts it also continues to progress and get worse over time.
What are the symptoms of age-related hearing loss?
Hearing loss is more than just difficulty hearing what a person is saying. There are several variations and symptoms that develop in a person who has age-related hearing loss. These include:
- Hearing mumbling or slurred speech when people talk
- Have trouble distinguishing sounds that are high-pitched
- Being unable to have or understand a conversation unless there is complete silence in the background
- Feeling that certain specific sounds are annoying and excessively louder than they should be
- Ringing in the ears, known as tinnitus
Consequences of age-related hearing loss
A person struggling with age-related hearing loss and its symptoms is likely to experience mood swings that can lead to depression and anxiety. Being isolated from others due to hearing loss can contribute to this feeling of isolation. Age-related hearing loss has also been associated with an increased risk of cognitive decline and dementia.
How is age-related hearing loss diagnosed?
Early diagnosis is crucial. This is because non-ageing hearing loss is correlated with other disorders, and if diagnosed and then treated earlier, some of these disorders can be prevented. Several different tests are used to identify hearing loss.
During the initial examination, a healthcare professional will examine the ear using a special endoscope with a light, otherwise known as a otoscope. They will check for any obvious damage or blockages in the ear.
Other tests used to identify hearing loss include the Weber and the Rinne, both of which use a type of tuning fork. In the Weber test, the tuning fork is placed on top of the head, while the Rinne test uses a tuning fork placed behind the ear. The forks are then struck to create a sound and the person being tested will transmit when the sound has stopped.
Another type of test, which acts as a type of questionnaire, can be done in people over 50. This type of test is known as a mini audio test (MAT) and allows people to self-identify the experiences they have with others based on their hearing abilities. A person is invited to complete the form with questions to find out if they agree, partially agree or disagree with the statement.
Statements about the MAT test include:
- Other people tell me that I have the television turned on too loudly.
- I can’t hear birds chirping or grasshoppers chirping very well.
- I have trouble following a conversation with another person on a moving train or bus.
- I have trouble understanding people when they whisper.
- My hearing difficulties lead to misunderstandings with my interlocutors.
- Other people tell me that I have difficulty hearing.
You should first make an appointment with your primary health care provider to express your concerns about your hearing. They can refer you to an audiologist who specializes in hearing health. Once it is clear that you have at least some hearing loss, you may be referred to a otolaryngologist, who is an ear, nose and throat (ENT) specialist. They will perform all required examinations and provide you with a treatment plan.
Treatment options for age-related hearing loss
The main treatment for age-related hearing loss is hearing aids. A hearing aid is an electronic medical device that is placed in or around the ear to help improve a person’s ability to hear sound.
People will get one hearing aid per ear and the devices can improve hearing. People who wear hearing aids should see their ear, nose and throat doctor regularly to make sure there are no issues with the hearing aid and their rehabilitation.
Other possible treatment options include:
- Devices capable of amplifying sound
- Devices capable of translating speech into text so that a person can read what a person is saying
- Learn lip-reading techniques, such as sign language
Is surgery an option for age-related hearing loss?
In rare cases, surgery may be done if there is injury, inflammation, or disease in the ear. However, there are risks associated with surgery, so it is not considered first-line treatment.
How is age-related hearing prevented?
There’s no real way to prevent age-related hearing loss, but there are ways to protect your ears from other factors that can contribute to it.
This involves keeping your ears healthy and avoiding excessive noise exposure. If you must be in very noisy areas, wearing earplugs or ear muffs can help limit the noise entering your ears.
Questions to ask your supplier
When you have hearing loss, you’ll want to make sure you get the most out of your appointment with your healthcare provider. To do this, you can ask questions such as:
- How quickly will my hearing deteriorate?
- Will I lose my hearing completely?
- What type of hearing loss do I have?
- What part of my ear is affected?
- Is the hearing loss the same in both ears?
- How do I choose the right hearing aid for me?
- Are hearing aids expensive and is there a way to offset the costs?
- Should I replace my hearing aids regularly?
- How often should I see my specialist about my hearing?
Age-related hearing loss is a type of progressive sensory loss that affects both ears as a person ages. The main cause of this type of hearing loss is age-related changes in the inner ear and auditory nerve function. Other factors, such as existing health conditions and genetics, can also play a role in whether or not a person develops age-related hearing loss.
Hearing loss acts as an umbrella term for many symptoms that occur due to this type of age-related loss, such as speech that sounds mumbled or garbled when people talk to you, feeling overwhelmed by certain sounds, and feeling ringing in the ears.
Although there is no way to prevent age-related hearing loss, early diagnosis can help find the right kind of treatment. Generally, hearing aids are the first choice when it comes to age-related hearing loss. They are very effective in restoring a person’s full sense of sound.
A word from Verywell
Not being able to hear people when they talk to you can be a frustrating experience. This is especially true if it’s new. Fortunately, it’s common to lose the ability to hear the way you once did as you age. Effective treatments can help restore your ability to hear and ensure that you don’t miss talking to friends, family, or others just because you’ve aged.
Frequently Asked Questions
At what age should hearing screening take place in the elderly?
Hearing screening tests should take place at any age if there is any indication that a person’s ability to hear is not what it should be. However, there is a typical age at which people should start screening so that any hearing loss is detected early. According to the US Preventive Services Task Force recommendation statement, people should begin regular hearing screenings once they reach age 50.
What are the three types of hearing loss?
The three types of hearing loss are sensorineural hearing loss, conductive hearing loss, and mixed hearing loss. Sensorineural hearing loss occurs when the inner ear and auditory nerve are damaged. Conductive hearing loss occurs when sound cannot enter the ear due to some blockage. Mixed deafness is a combination of the two. Age-related hearing loss is a type of sensorineural hearing loss.
What are the common consequences of age-related hearing loss in an elderly patient?
Older people who experience age-related hearing loss are often at increased risk of cognitive decline and dementia. They may also develop late-onset depression or anxiety, which may be driven by feelings of social isolation or isolation from friends and family.