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(Age-Related Hearing Loss)

Pronounced: Pres-bih-CUE-sis



Presbycusis is gradual slow loss of hearing that is happens as we age.

The Ear

Copyright © Nucleus Medical Media, Inc.


Causes    TOP

The inner ear senses vibration created by sound. Hair cells in this area changes the vibration into electric signals. These signals move through nerves to the brain so that you can hear. Over time this system can get worn down. The normal aging process can cause:

  • A wearing down of the inner ear
  • Changes in the bone structure of the middle ear
  • Changes in the nerves needed for hearing

Other factors that can cause damage over time include:

  • Regular exposure to loud noises—damages hair cells of the inner ear that are critical to hearing
  • Genetic factors

Risk Factors    TOP

Presbycusis is more common in:

  • Men
  • People over 75 years old
  • People with pale skin

Other factors that may raise your chance of presbycusis are:

  • Family history of hearing loss with aging
  • Hormones
  • Being around loud noises for work or hobbies
  • Smoking
  • Being overweight
  • Having health problems, such as:
    • Atherosclerosis
    • Diabetes
    • Problems with the immune system
    • Renal failure
    • Cerebrovascular disease

Symptoms    TOP

Hearing loss happens slowly over time in both ears. Common symptoms include:

  • Problems hearing high sounds, such as female voices, the phone ringing, or birds
  • Sounds that are not clear
  • Problems hearing people talking, such as in noisy places or while speaking on the phone
  • Ringing in one or both ears— tinnitus
  • Background sounds that are too loud or annoying
  • Ear fullness with or without vertigo, a feeling of spinning when you are not moving

Diagnosis    TOP

You will be asked about your symptoms and medical past. A physical exam will be done. The doctor will check your inner ear with a lighted tool. Some basic tests will help to check your hearing.

Other tests may include:

  • Audiometry —to check the level and amount of hearing loss
  • Weber test—to find out if the hearing loss is only on one side (rule out other causes)
  • Rinne test—to test if the hearing loss is because of nerve problems (rule out other causes)

Treatment    TOP

Hearing loss can't be reversed. The goal of treatment is to decrease impact of hearing loss on quality of life. Other steps may help to slow further hearing loss. Options include:

Helpful Habits

Steps that may improve your ability to hear include:

  • Stand closer to and face-to-face when you speak to people.
  • Repeat back what you hear to people speaking to make sure you understood them.
  • Ask people to rephrase things they say instead of asking them to repeat them.
  • Ask others speak louder and more clearly.
  • Try to lower 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. You may need to replace hearing aids with other models if your hearing loss gets worse.

There are also devices that can make voices over the phone more loud and clear.

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. It may improve the way sound reaches the brain. It can provide partial hearing to the profoundly deaf.


Prevention    TOP

To help reduce your chance of presbycusis:

  • Follow treatment plans to manage health problems that may cause hearing loss.
  • Avoid being around loud noises and sounds. This includes hazards at work, home, and during activities.
  • Protect your ears when you work with loud machinery or are in loud places.
  • If you smoke, talk to your doctor about how you can quit.
  • Talk to your doctor about supplements that may slow down age-related hearing loss.

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 website. Available at: https://www.nidcd.nih.gov/health/age-related-hearing-loss. Updated June 29, 2017. Accessed August 22, 2017.

Age-related hearing loss. American Speech-Language-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 September 2018 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 4/23/2018

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