Presbycusis: Age-related hearing loss

Age related hearing loss

Also known as Presbycusis, age-related hearing loss is the gradual loss of hearing that occurs as we age. A form of sensorineural hearing loss, age-related hearing loss commonly affects both ears and can make it harder to distinguish higher-pitched sounds, such as children's voices and ringing phones, impacting the way that we communicate and our day-to-day life. The severity of age-related hearing loss does vary from person to person, with some people unaware they are experiencing it due to its gradual nature.

The causes of presbycusis

Presbycusis, or age-related hearing loss, is primarily caused by changes in the inner ear as individuals age. With age, the tiny hair cells in our inner ear, also known as the cochlea, that transmit sound to our brains can begin to break down. When this happens, these hairs can't send signals as efficiently as before. This natural breakdown of the sensory cells and nerve fibres in the inner ear is the main contributor to presbycusis.

That being said, age is not the only aspect contributing to this condition. Chronic exposure to loud noises can affect the early onset of deterioration of these hair cells which accelerates presbycusis. There are also certain medical conditions, such as high blood pressure or diabetes, that can also hasten the deterioration of hair cells. This is because these medical conditions can affect the blood supply to the ear, leading to damage over time. Furthermore, genetic predisposition also plays a role in the development of presbycusis. Finally, some medications have been known to damage the inner ear, contributing to presbycusis. These are mainly "ototoxic" drugs, a category that includes certain antibiotics and some cancer treatments.


The symptoms of presbycusis

It can be hard to recognise that you are experiencing age-related hearing loss, mainly because of the gradual impact on your hearing but also because the symptoms of presbycusis or age-related hearing loss closely imitate the symptoms of other conditions.

Some of the most common signs and symptoms of age-related hearing loss can include:

  • Struggling to understand friends, family and co-workers in settings with background noise.
  • Feeling as though others are mumbling or slurring their words.
  • Finding it hard to distinguish high-pitched sounds ('s' and 'th' sounds, for example).
  • Needing to increase the volume of your television or radio to levels that are uncomfortable for others.
  • Men's voices may be easier to hear and understand than women's.
  • Some sounds seem very loud and irritating.
  • Avoiding some social settings in fear of not being able to understand others.
  • Tinnitus (a constant or intermittent ringing, humming or buzzing in one or both ears).

It is important to note that age-related hearing loss, just like any other form of hearing loss, does affect people differently. You may experience all the symptoms mentioned above or just a few. If you are experiencing any of the above symptoms, consult a healthcare professional or hearing specialist.

How is presbycusis diagnosed?

The diagnosis of presbycusis will begin by making an appointment with an audiologist to explore your medical history and perform a range of ear and hearing tests. To diagnose presbycusis, your audiologist will examine your ears to rule out any other causes of hearing loss, including looking for any visible abnormalities, blockages or infections.

A full hearing test will also be conducted to identify the extent of your hearing loss. The information from the hearing test is recorded on an audiogram so you can see how well you can hear different pitches of sounds. Typically presbycusis is associated with high frequency hearing loss that, over time, progresses to include lower pitches. Test results will vary from person to person and for how long the symptoms have presented themselves.

How to prevent hearing loss as we age

While, unfortunately, we cannot halt the natural ageing process, a few behaviours can help lessen the impact of age-related hearing loss over time. These include:

  • Avoiding repeated exposure to loud noise.
  • Ensuring you are protecting your ears using earplugs or earmuffs when exposed to loud noises.
  • Avoid using earbuds or headphones at loud volumes for extended periods.
  • Maintain a healthy lifestyle, including regular exercise and a balanced diet.
  • Avoid smoking.
  • Attend regular checkups with a healthcare provider and ensure you properly manage chronic conditions, such as diabetes or high blood pressure, which could otherwise contribute to hearing loss.

If you are concerned about your hearing health, book a free hearing check with Bay Audiology for a professional assessment.

Treatments for age-related hearing loss

If you believe you may be experiencing age-related hearing loss, a diagnostic hearing test at Bay Audiology can help determine the severity of your condition and what treatments are available.

Depending on the severity of age-related hearing loss, the condition can be managed in one of several different ways. These may include:

  • Being fitted with a hearing aid. A hearing aid is often the first line of treatment, amplifying sound, making it easier for the individual to hear and improving the wearer's quality of life.  Research also shows that treating hearing loss with a hearing aid has a positive impact on cognitive decline
  • Learning to use assistive devices, such as speech-to-text converters, amplifying devices and hearing loop systems.
  • Becoming proficient at lip reading and other management techniques.
  • In the case of having a very severe hearing loss, being fitted with a cochlear implant.
  • Removing any ear wax buildup from your ear.

Complications of age-related hearing loss

If left untreated, age-related hearing loss can lead to several complications. The most common and obvious impact is the loss of communication. When an individual struggles to hear, it can make it difficult to communicate in everyday life. This may include a failure to respond to warnings, not hearing phones ringing, missing alarms and struggling to hold meaningful conversations, especially those held over a phone or in a noisy environment. Taking away an individual's ability to communicate can lead to irritation, frustration, embarrassment,social isolation and loneliness and depression. 

If hearing loss is untreated for long periods, it can lead to cognitive decline. Some studies have suggested a link between hearing loss and cognitive disorders such as dementia. While more research needs to be conducted to make conclusive statements about why this is, theories suggest that the extra mental effort required to comprehend speech strains the brain, leading to a cognitive decline. Another view is that hearing loss leads to social isolation, which is another known risk factor for cognitive decline.

When to seek help

If you believe you are suffering from some of the symptoms of presbycusis, or you believe a family member or loved one may be, seeking help as soon as possible is vital. Early intervention can be beneficial in slowing the progression of hearing loss and improving an individual's overall quality of life. Regular checkups can help to detect age-related hearing loss in its early stages, allowing you to get the help you need.

Frequently asked questions

What per cent of people between the ages of 45 and 65 suffer from presbycusis?

According to the World Health Organisation, approximately one-third of people over the age of 65 are affected by disabling hearing loss.

What causes presbycusis?

Some of the most common causes of age-related hearing loss include:

  • Changes within the inner and middle ear occur as we age.
  • Repeated exposure to loud noises at work or home.
  • Health conditions, such as diabetes and heart disease.
  • Some inherited conditions.
  • Adverse reactions to some medications, including antibiotics and chemotherapy.


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