What is Hearing Loss?
Hearing loss is a common problem caused by noise, aging, disease, and heredity. Hearing is a complex sense involving both the ear's ability to detect sounds and the brain's ability to interpret those sounds, including the sounds of speech. Factors that determine how much hearing loss will negatively affect a person’s quality of life include
- the degree of the hearing loss
- the pattern of hearing loss across different frequencies (pitches)
- whether one or both ears is affected
- the areas of the auditory system that are not working normally—such as the middle ear, inner ear, neural pathways, or brain
- the ability to recognize speech sounds
- the history of exposures to loud noise and environmental or drug-related toxins that are harmful to hearing
A Common Problem in Older Adults
Hearing loss is one of the most common conditions affecting older adults. Approximately 15 percent (37.5 million) of American adults ages 18 and older report some degree of hearing loss. Men are more likely to experience hearing loss than women.
Approximately 28.8 million U.S. adults could benefit from using hearing aids, but only one in four U.S. adults ages 20 and over who could benefit from hearing aids has used them.
People with hearing loss may find it hard to have a conversation with friends and family. They may also have trouble understanding a doctor's advice, responding to warnings, and hearing doorbells and alarms
(Watch the video to learn more about older adults and hearing loss. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)
Types of Hearing Loss
Hearing loss comes in many forms. It can range from a mild loss in which a person misses certain high-pitched sounds, such as the voices of women and children, to a total loss of hearing. It can be hereditary or it can result from disease, trauma, certain medications, or long-term exposure to loud noises.
There are two general categories of hearing loss.
- Sensorineural hearing loss occurs when there is damage to the inner ear or the auditory nerve. This type of hearing loss is usually permanent.
- Conductive hearing loss occurs when sound waves cannot reach the inner ear. The cause may be earwax build-up, fluid, or a punctured eardrum. Medical treatment or surgery can usually restore conductive hearing loss.
What is Presbycusis?
One form of hearing loss, presbycusis, comes on gradually as a person ages. Presbycusis, or age-related hearing loss, can occur because of changes in the inner ear and auditory nerve. Having presbycusis may make it hard for a person to tolerate loud sounds or to hear what others are saying.
Presbycusis commonly affects older adults, many of whom are likely to lose some hearing each year. Approximately one in three people between the ages of 65 and 74 has hearing loss and nearly half of those older than 75 have difficulty hearing.
Age-related hearing loss most often occurs in both ears, affecting them equally. Because the loss is gradual, if you have age-related hearing loss you may not realize that you’ve lost some of your ability to hear.
Tinnitus: A Common Symptom
Tinnitus, also common in older people, is typically described as ringing in the ears, but it also can sound like roaring, clicking, hissing, or buzzing. It can come and go. It might be heard in one or both ears and it may be loud or soft. Tinnitus can accompany any type of hearing loss and can be a sign of other health problems as well.
Tinnitus is a symptom, not a disease. It can accompany any type of hearing loss. It can be a side effect of medications. Something as simple as a piece of earwax blocking the ear canal can cause tinnitus, but it can also be the result of a number of health conditions. Roughly 10 percent of the U.S. adult population, or about 25 million Americans, has experienced tinnitus lasting at least five minutes in the past year.
If you think you have tinnitus, see your primary care doctor. You may be referred to an otolaryngologist—a doctor who specializes in the medical and surgical care of ear, nose, and throat diseases—also commonly called an ear, nose, and throat doctor, or an ENT. The otolaryngologist will physically examine your head, neck, and ears and request a hearing test by an audiologist.
Hearing Loss Can Lead to Other Problems
Some people may not want to admit they have trouble hearing. Older people who can't hear well may become depressed or may withdraw from others to avoid feeling frustrated or embarrassed about not understanding what is being said. Sometimes older people are mistakenly thought to be confused, unresponsive, or uncooperative just because they don't hear well.
Hearing problems that are ignored or untreated can get worse. If you have a hearing problem, you can get help. See your doctor. Hearing aids, special training, certain medicines, and surgery are some of the choices that can help people with hearing problems.