Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

Presbycusis is gradual hearing loss in both ears that commonly occurs as people age. This form of gradual hearing loss can be mild, moderate, or severe. Presbycusis that leads to permanent hearing loss may be referred to as nerve deafness.

The Ear

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Causes

There are several causes of presbycusis including:

  • Gradual degeneration of the inner ear
  • Changes in the bone structure of the middle ear, a condition called otosclerosis
  • Changes in the hearing nerve pathways in the ear leading to the brain
  • Repeated exposure to loud sounds, music, or equipment which can damage the fragile hair cells within the inner ear involved in hearing
  • Hereditary or genetic influences

Risk Factors

Presbycusis is more common in men, and in people over 75 years old. Other factors that may increase your chance of presbycusis include:

  • Family history of gradual hearing loss with advancing age
  • Noise exposure
  • Smoking
  • Having certain health conditions, such as:
    • Cardiovascular disease, high blood pressure, or other circulatory problems
    • Diabetes
    • Metabolic bone disease, such as Pagets disease
    • Renal failure
    • Trauma
    • Vestibular schwannoma
    • Infection
    • Immune function impairment

Symptoms

Presbycusis may cause:

  • Noticeable loss of hearing of higher-pitched sounds, such as female voices, telephone ringing, or bird calls
  • Sounds that appear less clear and sharp
  • Difficulty understanding conversations, particularly in noisy places or while speaking on the telephone
  • Ringing in one or both ears—tinnitus
  • Background sounds appear overly loud or bothersome
  • Ear fullness with or without vertigo, a feeling of spinning when you are not moving

With presbycusis, hearing loss is usually very gradual, affecting both ears equally.

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. The doctor will perform a visual exam of your ear canal and eardrum with a lighted instrument called an otoscope.

Tests may include the following:

  • Rinne test—to test if the hearing loss is nerve related
  • Weber test—to determine if the hearing loss is one-sided
  • Audiometry—to determine level and extent of hearing loss

Treatment

Treatment options include the following:

Stand closer to and face-to-face with people you are speaking to.

Have others speak louder and more clearly.

Try to reduce background noise.

If it is determined that a hearing aid may be useful, the audiologist will conduct several tests to determine the type of hearing aid that will best improve hearing of speech. The extent of benefit varies according to the cause and degree of hearing loss. Sometimes hearing aids will need to be replaced with other models if hearing loss progresses. Some people with presbycusis may benefit from telephone amplifiers that help hear speech on the telephone.

For certain people with very severe hearing loss that is not improved by a simple hearing aid, a cochlear implant device may improve sound generation to the brain. It may provide partial hearing to the profoundly deaf.

Prevention

To help reduce your chance of presbycusis:

  • Follow treatment plans that help manage health conditions that may cause hearing loss.
  • Avoid repeated exposure to loud noises and sounds of any type, including those at work, home, and during recreation.
  • When working with loud machinery or in loud environments, wear protective ear plugs or ear muffs.
  • If you smoke, talk to your doctor about how you can quit.