Age-related hearing loss

Causes

Tiny hairs inside your ear help you hear. They pick up sound waves and change them into the nerve signals that the brain interprets as sound. Hearing loss occurs when the tiny hairs inside the ear are damaged or die. The hair cells do not regrow, so most hearing loss is permanent.

There is no known single cause for age-related hearing loss. Most commonly, it is caused by changes in the inner ear that occur as you grow older. However, your genes and loud noises (such as from rock concerts or music headphones) may play a large role.

The following factors contribute to age-related hearing loss:

• Family history (age-related hearing loss tends to run in families)
• Repeated exposure to loud noises
• Smoking (smokers are more likely to have such hearing loss than nonsmokers)

Certain medical conditions and medications also contribute to age-related hearing loss. About half of all people over age 75 have some amount of age-related hearing loss.

Symptoms

The loss of hearing occurs slowly over time. It is most difficult to hear high-frequency sounds, such as someone talking. As hearing gets worse, it may become difficult to hear sounds at lower pitches.

Symptoms include:

• Certain sounds seem overly loud
• Difficulty hearing things in noisy areas
• High-pitched sounds such as "s" or "th" are hard to distinguish from one another
• Men's voices are easier to hear than womens.
• Other people's voices sound mumbled or slurred
• Ringing in the ears

The symptoms of presbycusis may resemble other conditions or medical problems. Talk to you health care provider if you have any of these symptoms.

Exams and Tests

A complete physical exam is performed to rule out medical conditions that can cause hearing loss. The health care provider will use an instrument called an otoscope to look in your ears. Sometimes, wax can block the ear canals and cause hearing loss.

You may be sent to an ear, nose, and throat doctor and a hearing specialist (audiologist). Hearing tests can help determine the extent of hearing loss.

Treatment

There is no known cure for age-related hearing loss. Treatment is focused on improving your everyday function. The following may be helpful:

• Hearing aids
• Telephone amplifiers and other assistive devices
• Sign language (for those with severe hearing loss)
• Speech reading (such as lip reading and using visual cues to aid communication)

A cochlear implant may be recommended for certain people with very severe hearing loss. Surgery is done to place the implant. The implant makes sounds seem louder, but does not restore normal hearing.

Outlook (Prognosis)

Age-related hearing loss is progressive, which means it slowly gets worse. The hearing loss is permanent.

Possible Complications

Hearing loss can result in both physical (not hearing a fire alarm) and psychological (social isolation) problems.

The hearing loss may lead to deafness.

When to Contact a Medical Professional

Hearing loss should be evaluated as soon as possible to rule out potentially reversible causes such as too much wax in the ear or medication side effects. It is also helpful to have a baselines hearing test so your doctor can note any changes that may occur in the future.

Contact your health care provider immediately if you have a sudden change in your hearing or hearing loss with other symptoms such as headache, vision changes, or dizziness.

Alternative Names

Hearing loss - age related; Presbycusis

Update Date: 12/13/2010

Updated by: Michael Langan, M.D. Department of Geriatrics, Massachusetts General Hospital, Boston, MA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.