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(Age-Related Hearing Loss)

Pronounced: Pres-bih-CUE-sis


Presbycusis is the gradual loss of hearings that is associated with aging. High pitched sounds are lost more often or earlier than low-pitched sounds.

The Ear

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Causes    TOP

Presbycusis is caused by changes that occur with age. There are several possible causes of presbycusis such as:

  • 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    TOP

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    TOP

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. It affects both ears equally.

Diagnosis    TOP

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    TOP

Treatment options include the following:

Environmental changes

Steps that may help your ability to hear include:

  • Stand closer to and face-to-face with people you are speaking with.
  • Ask others speak louder and more clearly.
  • Try to reduce background noise.

Hearing Aids and Assistive Listening Devices

Talk with a specialist to see if a hearing aid is right for you. An audiologist will then be able to do tests to find the best type of hearing aid for you. Sometimes hearing aids will need to be replaced with other models if your hearing loss gets worse.

Other devices like a telephone amplifier may also help. It will make speech over the phone clearer for you.

Cochlear Implants    TOP

A hearing aid may not be helpful for severe hearing loss. Some with this type of hearing loss may benefit from a cochlear implant device. It may improve sound generation to the brain. The implant can provide partial hearing to the profoundly deaf.

Prevention    TOP

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. This includes hazards 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.


American Academy of Otolaryngology—Head and Neck Surgery
American Tinnitus Association


Canadian Hearing Society
Canadian Society of Otolaryngology


Age-related hearing loss. National Institute on Deafness and Other Communication Disorders (NIDCD) website. Available at: Updated June 29, 2017. Accessed August 22, 2017.
Age-related hearing loss. American Speech-Lnaguage-Hearing Association. Available at:
...(Click grey area to select URL)
Accessed August 22, 2017.
Gates GA, Mills JH. Presbycusis. Lancet. 2005;366(9491):1111-1120.
Huang Q, Tang J. Age-related hearing loss or presbycusis. Eur Arch Otorhinolaryngol. 2010 Aug;267(8):1179-91
Last reviewed January 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 2/7/2018

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