What Is presbycusis?
Presbycusis, pronounced prez-buh-KYOO-sis, is the gradual decline in hearing that comes with age. It’s one of the most common conditions affecting older adults. This hearing loss usually begins in your 50s or 60s and progresses slowly, often going unnoticed until it starts interfering with your daily life.
Symptoms of presbycusis
People with presbycusis may experience these symptoms:
- Muffled or unclear sounds: Like listening to a poorly tuned radio
- Difficulty with high-pitched sounds: Children’s or women’s voices may especially be hard to hear
- Challenges in noisy environments: Conversations in crowded spaces becomes harder
- Tinnitus: A persistent ringing, buzzing, or clicking sound in the ears
- Struggles with phone conversations: Words may sound unclear or incomplete
- Asking others to repeat themselves often: You may miss parts of conversations and ask people to repeat themselves often so you can follow along
These symptoms can lead to frustration and social withdrawal, which can potentially damage your mental and emotional well-being.
Causes of presbycusis
The primary causes of age-related hearing loss include:
- Inner ear changes: Gradual damage to hair cells in the cochlea (part of the inner ear involved in hearing)
- Genetics: A family history of hearing loss makes it more likely you’ll get it
- Lifelong noise exposure: Prolonged exposure to loud sounds from concerts, work environments, or hobbies
- Chronic health conditions: Diabetes, heart disease, high blood pressure, and kidney disease
- Lifestyle factors: Smoking and certain medications (e.g., chemotherapy drugs) can contribute to hearing loss
Diagnosing presbycusis
In order to be diagnosed with age-related hearing loss, you’ll need to see a doctor, like an audiologist.
An audiologist will do the following to diagnose your presbycusis:
- Use an otoscope to examine the ear for physical issues, such as wax buildup or damage.
- Conduct a hearing test using headphones, assessing your response to tones and spoken words. The audiologist charts your results on an audiogram, which helps identify the type and severity of hearing loss. You get a copy of this audiogram when you’re done.
When to see a doctor
Seek a hearing evaluation or see a doctor right away if you experience sudden or rapid hearing loss, sudden tinnitus, or balance problems.
It’s important you get regular check-ups so you can spot any issues and treat them early before they get worse.
Treatments for age-related hearing loss
Presbycusis has no cure, but you can improve your ability to hear with these treatments:
1. Hearing aids
Hearing aids amplify sounds, making speech clearer and reducing the effort required to listen. Modern hearing aids include features such as:
- Noise reduction: Helps in noisy environments
- Directional microphones: Focuses on sounds in front of you
- Connectivity: Links to smartphones or TVs for streaming audio
- Tinnitus masking: Plays soothing sounds to counteract tinnitus
2. Cochlear implants
For severe hearing loss only, cochlear implants can bypass damaged hair cells to stimulate the auditory nerve directly.
3. Counseling and therapy
Therapeutic interventions, like counseling or cognitive behavioral therapy (CBT), can address the emotional challenges of hearing loss and help improve your mental health.
4. Assistive listening devices (ALDs)
Devices like amplified telephones or TV listening systems enhance specific sounds for easier hearing.
Choosing a hearing aid for presbycusis
When selecting a hearing aid for presbycusis, consider the following factors:
- Hearing aid type/style: Style will depend on your degree of hearing loss and what you prioritize: Do you want an invisible hearing aid no one notices? Or do you only care about power and functionality? Common hearing aid styles include behind-the-ear (BTE), in-the-ear (ITE), in-the-canal (ITC), or completely-in-canal (CIC).
- Degree of hearing loss: Severe cases may require more powerful devices like BTE models.
- Lifestyle: Features like noise reduction may be helpful for more active people
- Dexterity: Larger models may be easier to handle for people with arthritis or vision impairments
- Budget: Prices range from $100 (OTC devices) to $7,000+ (advanced prescription models)
- Extra features: Look for Bluetooth connectivity, rechargeable batteries, and tinnitus-masking options
How to prevent age-related hearing loss
While presbycusis isn’t entirely preventable, take the following steps to protect your hearing:
- Minimize loud noise exposure: Use earplugs or earmuffs during concerts or around loud machinery.
- Practice safe listening habits: Keep device volumes low. Experts recommend keeping your volume at 60% or lower in your headphones.
- Avoid smoking: Smoking increases the risk of hearing loss.
- Maintain cardiovascular health: Heart disease and poor circulation can damage the function of your inner ear.
Hearing aids and cognitive health
Untreated hearing loss can increase the risk of cognitive decline, dementia, and depression, according to research. Using hearing aids or other corrective devices is linked to a reduced risk of long-term cognitive issues in people considered high-risk. This makes it even clearer why early intervention is so important—the earlier you address your hearing loss, the easier it’ll be to treat it.