What is Presbycusis?

Presbycusis is age-related hearing loss in both ears. Hearing loss is a common part of aging, but it does not have to limit your quality of life. There are ways to manage hearing loss, such as using hearing aids. Hearing loss associated with presbycusis tends to be gradual over time, which can make it hard for adults to even be aware that they have experienced hearing loss. Typically, a person will lose the ability to hear higher pitched noises, such as a phone ringing or an appliance beeping. Lower tones tend to not be affected.

It is important to consult with your doctor regarding hearing loss. Left untreated, it could lead to communication issues, social isolation, depression, anxiety, or put you in danger of not hearing warning alarms, sirens, or smoke detectors.

Signs and Symptoms

The most common symptom of presbycusis is hearing loss. The symptoms may manifest as having issues related to:

• Difficulty hearing higher pitched sounds such as electronic tones, alarms, or children’s voices
• Speech of others sound mumbled or slurred
• Having to turn the volume up on the TV, radio, or electronic device
• Having to read lips when others are speaking to you
• Difficulty understanding speech in a loud, noisy, or crowded places with a lot of background noise
• Tinnitus (ringing, buzzing, roaring, or “cricket” sounds in one or both ears)
• Some sounds seem overly loud or irritating
• Male or lower registered voices are easier to hear than higher-pitched female voices or children’s voices
• Higher pitched letter sounds, such as the “s” or “th” sounds are more difficult to distinguish

Causes

The causes for age-related hearing loss vary among individuals. Causes of presbycusis include:

• Changes within the inner ear (most common)
• Changes within the middle ear
• Changes along the nerve pathways to the brain
• Loss of hair cells (sensory receptors in the inner ear)
• Genetics
• Aging
• Smoking
• Chronic exposure to loud noises (music, work, etc.)
• Health conditions such as diabetes, heart disease, or high blood pressure
• Side effects of certain medications (aspirin or certain antibiotics)
• Infection

Risk Factor

Risk factors for developing age-related hearing loss include:

• Family history of presbycusis
• Certain health conditions (diabetes, heart disease, high blood pressure)
• Chronic exposure to loud noises
• Use of certain medications (aspirin or certain antibiotics)
• Smoking
• Aging
• Low socioeconomic status
• Being Caucasian
• Infections

Diagnosis

To diagnose aged-related hearing loss, a doctor will use an otoscope, which is a lighted scope that examines the outer ear canal and eardrum. Your doctor will be looking for signs of inflammation, blockage from earwax or a foreign object, damage to the eardrum, or for an infection.

Your doctor may also refer you to an audiologist. An audiologist will run a series of tests using an audiogram that plays sounds through headphones. Typically, the tests require you to identify different tones and repeat back words that are played through headphones to one ear at a time. If a person is unable to hear the tones it would signify some sort of hearing loss.

Treatment

Your healthcare provider will determine the best course of treatment for your hearing loss based on your age, severity of symptoms, and overall health. Treatments for age-related hearing loss include:

• Hearing aids
• Assistive devices, such as a phone amplifier, technology that changes spoken words into text, or closed-circuit systems in large auditoriums
• Cochlear implants, which are small electrical devices that are surgically implanted and help to stimulate the auditory nerve
• Training in speechreading (learning to use visual cues to determine what is being said)
• Techniques for preventing excess wax buildup in the outer ear

Prevention

There is no known way to prevent age-related hearing loss. However, there are a few ways to reduce or slow down age-related hearing loss. Strategies include:

• Minimizing your exposure to chronic noise and loud sounds
• Wearing earplugs or special fluid-filled earmuffs to prevent any further damage to your hearing
• Managing health conditions, such as diabetes and hypertension (high blood pressure)
• Keeping the volume turned down on the TV, radio, or other listening devices

Complications

If your hearing loss is significant, you may need hearing aids or other assistive devices to help you communicate with others. Hearing loss can lead to several complications. These complications may include:

• More likely to miss hearing or understanding pertinent information (i.e., health, financial, or legal information)
• Less ability to connect and engage social with others, which may lead to withdrawing and social isolation
• Depression
• Anxiety
• Loneliness
• May cause someone to miss important meetings, such as medical appointments or follow-ups due to embarrassment over hearing loss
• Safety issues, such as not being able to hear a car horn, fire alarm, or warning sirens