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Presbycusis (Age-Related Hearing Loss) in the Elderly

Presbycusis (Age-Related Hearing Loss) in the ElderlyAge-related hearing loss, known as presbycusis, is a gradual and progressive diminishing of the sense of hearing in older people. It is a very common condition after the age of 65 years and starts as early as the 50s. Presbycusis does not occur overnight and will not lead to deafness within a short period of time. Instead the hearing apparatus within the year becomes less sensitive over years and decades. Although presbycusis he’s a medical condition, it is not considered to be a disease as such. Rather it is seen as a physiological change associated with aging.

Causes of Presbycusis

Sound waves are directed by the outer ear into the ear canal. Here it causes the ear \drum to vibrate which in turn moves the small bones within the middle ear known as the ossicles. The vibration is then transmitted into the inner ear to a specialized hearing organ known as the cochlea. Here tiny hair cells move in response to the vibration and generates nerve impulses which then travel back to the brain to be deciphered as the sense of sound.

In presbycusis, these tiny hair cells begin to shrink and die off. It is an irreversible change although there is current research being done in the role of stem cells to restore these tiny hairs. Although this is the main mechanism for presbycusis, there may also be some changes within the middle ear and nerves relaying impulses created by sound to the brain. Ultimately it leads to progressive hearing loss mainly in the elderly.

Presbycusis may affect any older person but is more likely to occur in a person who has been exposed to loud noise for long periods in their life – often related to working in noisy environments. Other risk factors associated with presbycusis includes cigarette smoking, heart disease and high blood pressure (hypertension).

Symptoms of Presbycusis

Presbycusis presents with gradual loss of hearing although it can be so mild that a person may not be aware that they are hard of hearing. Presbycusis should not be confused with tinnitus, which is also very common in the elderly. Tinnitus is the perception of sound, usually described as a ringing in the ears, when there is no sound in the environment. It is a symptom of presbycusis but may also occur in other hearing and ear disorders.

A person may be unable to clearly identify and the age related hearing loss and therefore other features need to be noted. This includes :

  • Listening to the TV or radio at a loud volume to be able to hear.
  • Difficulty understanding the speech of others and complaining that others are speaking in a garbled or mumbled manner.
  • Some sounds may seem extremely loud when it is not to others.
  • Difficulty with hearing high pitched sounds.

Treatment of Presbycusis

There is no specific treatment to undo the loss of hearing in presbycusis. Prevention earlier in life is a major factor, especially for those who are working in noisy environments. Special industrial earmuffs or earplugs should be worn at all times to reduce the damage on the hearing apparatus of the year. Once a person has presbycusis, certain assistive listening devices may be of use. The main such device is a hearing aid. For those with limited difficulty, special listening devices need only be used in certain instances – like a telephone amplifier.

Living with Presbycusis

While hearing aids and telephone assistive living devices are helpful in dealing with the impact of presbycusis, it is not a treatment. Ultimately an elderly person has to learn to live with the impact of age-related hearing loss and living companions and loved ones should help them cope with this problem. Presbycusis fortunately does not totally remove one’s independence and rather than seeing it a burden with age, one should embrace life and not let this ailment hamper daily activities and recreation in the senior years.


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