Presbycusis

Presbycusis

Presbycusis is age-related hearing loss. This is a common condition that begins in middle age and develops slowly over time. Presbycusis usually affects both ears. This condition is permanent and cannot be corrected with surgery. However, hearing aids can help with this condition.

What are the causes?

This condition is caused by age-related changes in the inner or middle ear. These changes usually affect parts of the spiral-shaped cavity that translates sounds into nerve signals that are sent to the brain (cochlea).

What increases the risk?

The following factors may make you more likely to develop this condition:

  • Older age.
  • Being male.
  • Exposure to loud noises.
  • Exposure to medicines or substances that are poisonous (toxic) to organs in the ear. For example, chemotherapy drugs can sometimes affect hearing.
  • Having certain medical conditions, such as:
    • High blood pressure (hypertension).
    • Diabetes.
    • Diseases that affect the body’s disease-fighting system (immune diseases).
    • Heart diseases.
    • High cholesterol.
  • Smoking.
  • Having a history of ear infections.
  • Having a family history of age-related hearing loss.

What are the signs or symptoms?

The main symptom of this condition is hearing loss that develops slowly with age. Generally, it affects both ears. Signs of hearing loss can include:

  • Asking people to repeat themselves often.
  • Difficulty hearing people over the phone.
  • Difficulty following conversations when multiple people are talking.
  • Difficulty hearing when there is background noise, such as at a restaurant or bar.
  • Difficulty hearing high-pitched sounds, such as children speaking.
  • Turning the television volume up to levels that are higher than normal.
  • Talking loudly.

Other symptoms include:

  • Roaring, ringing, hissing, or buzzing in the ears (tinnitus).

How is this diagnosed?

This condition may be diagnosed based on:

  • Your medical history.
  • An ear exam. Your health care provider will look into your ears to check whether there may be another cause of your hearing loss, such as earwax buildup.
  • A hearing test (audiogram). This test will see whether you can hear different tones at different pitches.

Your health care provider may also refer you to an ear, nose, and throat specialist (otolaryngologist) or a hearing loss specialist (audiologist) who can assess your hearing loss and identify the cause.

How is this treated?

There is no cure for this condition, but treatment can help you hear better. Treatment may include:

  • Hearing aids.
  • A hearing device that is placed in the cochlea (cochlear implant).
  • Other devices to help you hear (assistive listening devices), such as electronic devices or apps.
  • Strategies to help with hearing in daily life (auditory rehabilitation).
  • Lip reading training.

Follow these instructions at home:

Communicating with others

  • Tell your family and friends about your hearing loss. Once they know, they will be able to communicate better with you and help you cope.
  • When talking with others, face them so you can see their lips move while they talk. Watch their hand gestures and facial expressions to help you interpret what they say. Ask people to:
    • Get your attention before they start talking to you.
    • Speak more clearly, slowly, or loudly (but not shout).
    • Face you when they are talking.

Coping with hearing loss

  • Consider using assistive listening devices at home and at work, such as:
    • Electronic devices that are linked with hearing aids to help you hear on the telephone. These can also be hooked up to sound systems in certain places such as theaters.
    • Apps for smartphones and tablets that can help translate speech to text.
    • Alerting devices. These play a loud sound or flash a light to indicate a doorbell or alarm.
  • Avoid loud noises.
  • Avoid or decrease background noise as much as possible.
    • Turn off the TV and radio when you are not actively listening to it.
    • Avoid noisy spots in public places. For example, when in a restaurant, ask for a table away from the kitchen or bar.
  • Consider adding carpet to your home to absorb excess noise.
  • Consider adding extra lighting to your home to help you see people when they are talking to you.

General instructions

  • If you need a hearing aid, have it fitted by a specialist. Do not buy hearing aids unless you have had a hearing aid evaluation.
  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • Your hearing gets worse, even with treatment.
  • You feel isolated or become depressed.
  • You have a fever.
  • You have new ringing or buzzing in your ear.

Get help right away if:

  • You lose hearing suddenly (over a few hours or a day).
  • You have numbness, especially in parts of your face.
  • You have ear or head pain.
  • You are confused.
  • You are bleeding from your ear.
  • You experience dizziness on a regular basis.

Summary

  • Presbycusis is age-related hearing loss that begins in middle age and develops slowly over time.
  • This condition is caused by age-related changes in the inner or middle ear.
  • You are more likely to develop this condition if you are older, male, take certain medicines, are exposed to loud noises, have certain health conditions, or have a family history of hearing loss.
  • Presbycusis usually affects both ears.
  • Treatment may include hearing aids, a hearing device that is placed in a cavity in the inner ear (cochlear implant), lifestyle changes, lip reading, and assistive listening devices.
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