Presbycusis: Age-Related Hearing Loss

Please Turn the TV Up Louder

As millions of baby boomers age, many are having their first experiences with hearing loss, however slight it may be. This aging-associated hearing loss is known as presbycusis. If an older person close to you has started to say things like "what?" more often, or turns up the volume on entertainment devices more often, this may indicate that he or she has presbycusis. Another possible indicator is that he or she is having a harder time understanding people in a noisy place.

If so, he or she is in plenty of company -- about 30 to 35 percent of adults between the ages of 65 and 75 have some hearing loss, as do 40-50 percent of people age 75 and older. Many may not even be aware that they have hearing loss.

More Symptoms of Presbycusis

In addition to the above, there are more symptoms of presbycusis. These symptoms include hearing voices as slurred or mumbled, and having an easier time understanding a man than a woman. Another symptom is tinnitus, a ringing in the ears.

What Happens in Presbycusis?

In presbycusis, the nerves or hair cells in the inner ear -- where the cochlea is -- start to deteriorate, becoming dead or damaged. The loss of the hair cells makes it harder to hear. Thus, presbycusis is often a type of sensorineural hearing loss, although it can also sometimes be conductive.

This degeneration affects both ears and begins when a person is still young -- only 20 years old.

However, once a person is between 55 and 65 years old, that is when progressive hearing loss begins, usually in the higher frequencies. (An example of a higher frequency sound is the sound of the phone ringing.)

Presybcusis can also result from changes in the middle ear as a person ages, or from changes in the nerve pathways going to the brain.

Risk Factors for Presbycusis

Getting older is not the only factor in presbycusis. Other risk factors include genetics, as some people may have a genetic predisposition for losing hearing. Another risk factor is noise exposure. Older people may have had a lot of exposure to loud noise for years, and this results in cumulative hearing damage. Being a smoker is another risk factor. Heart disease and high blood pressure can also affect the flow of blood to the ear, leading to hearing loss.

Is There Any Way to Prevent Presbycusis?

Maybe. An animal study was done with mice that were divided into early, late, and no treatment groups. Before beginning treatment, and every three months afterwards, the mice were given auditory brainstem response (ABR) tests to check their hearing ability. Mice in the treatment groups were given six antioxidants.

The results showed that the mice who did not get any treatment had greater threshold shifts from their baseline level of hearing. The untreated mice had more hearing loss (34.7 db) than the mice who did get treatment.

The mice who received treatment had much lower threshold shifts. For example, the early treatment group shifted only 7.5 decibels, and the late treatment group shifted 9.2 decibels. These results were enough for the authors to conclude that antioxidant treatment works in animals, at least. Therefore, with more research, it is possible that antioxidant treatment could someday prevent presbycusis from developing in aging people.

Importance of Treating Presbycusis

It is apparently very important to treat presbycusis promptly, with hearing aids or cochlear implants. (Using assistive listening devices or amplifiers is another option.) People with presbycusis may also benefit from learning lipreading (speechreading) skills or sign language.

Hearing loss due to presbycusis can be mild, or it can be moderate/severe. A study of 639 people between ages 36 and 90 years old found that hearing loss is associated with dementia. It is not yet known why that is, but experts have some theories. One theory is that because having hearing loss often causes older people to withdraw socially due to the frustration that they experience, that very withdrawal unfortunately can contribute to the progress of dementia. Another theory is that when hearing loss arises in an older person, the brain may redistribute its resources, taking away resources from cognitive capabilities and putting them towards hearing instead.


Audiology Information Series: Common Causes of Hearing Loss in Adults. American Speech-Language-Hearing Association.

Hearing Loss and Incident Dementia. Frank R. Lin; E. Jeffrey Metter; Richard J. O’Brien; Susan M. Resnick; Alan B. Zonderman; Luigi Ferrucci. Archives of Neurology. 2011;68(2):214-220.

Heman-Ackah SE, Juhn SK, Huang TC, Wiedmann TS. A combination antioxidant therapy prevents age-related hearing loss in C57BL/6 mice. Otolaryngology-Head and Neck Surgery. 2010 Sep;143(3):429-34.

Presbycusis. National Institute on Deafness adn Other Communication Disorders.

Treat hearing loss sooner, not later; it's linked with a higher risk of dementia: research shows that people who have trouble hearing are more likely to suffer from cognitive decline. Women's Health Advisor. July 2011 v15 i7 p3(1).

Continue Reading