Hearing Loss: A Common Problem for Older Adults
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Hearing loss is a common problem caused by loud noise, aging, disease, and genetic variations. About one-third of older adults have hearing loss, and the chance of developing hearing loss increases with age. People with hearing loss may find it hard to have conversations with friends and family. They may also have trouble understanding a doctor’s advice, responding to warnings, and hearing doorbells and alarms.
Some people may not want to admit they have trouble hearing. Hearing problems that are ignored or untreated can get worse. If you have a hearing problem, see your doctor. Hearing aids, special training, certain medications, and surgery are some of the treatments that can help.
Signs of hearing loss
Some people have a hearing problem and don’t realize it. You should see your doctor if you:
- Have trouble understanding what people are saying over the telephone
- Find it hard to follow conversations when two or more people are talking
- Often ask people to repeat what they are saying
- Need to turn up the TV volume so loud that others complain
- Have a problem understanding speech because of background noise
- Think that others seem to mumble
- Can’t understand what's being said when children and people with higher pitched voices speak to you
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, to a total loss of hearing.
Sudden hearing loss
Sudden deafness, also known as sudden sensorineural hearing loss, is an unexplained rapid loss of hearing. It can happen to a person all at once or over a period of a few days. It should be considered a medical emergency. If you or someone you know experiences sudden hearing loss, visit a doctor immediately.
Age-related hearing loss
Age-related hearing loss, also called presbycusis, comes on gradually as a person grows older. It seems to run in families and may occur because of changes in the inner ear and auditory nerve, which relays signals from the ear to the brain. Presbycusis may make it hard for a person to tolerate loud sounds or to understand what others are saying.
Age-related hearing loss usually occurs in both ears, affecting them equally. Because the loss is gradual, people with presbycusis may not realize they have lost some of their ability to hear.
Tinnitus is also common in older people. It 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 can be heard in one or both ears, and it may be loud or soft. Tinnitus is sometimes the first sign of hearing loss in older adults. It can accompany any type of hearing loss.
Tinnitus is a symptom, not a disease. Something as simple as a piece of earwax blocking the ear canal can cause tinnitus. It can also be a sign of other health conditions, such as high blood pressure or allergies. Tinnitus can also occur as a side effect of certain medications.
Causes of hearing loss
Loud noise is one of the most common causes of hearing loss. Noise from lawn mowers, snow blowers, or loud music can damage the inner ear and result in permanent hearing loss. Loud noise also contributes to tinnitus. You can prevent most noise-related hearing loss by turning down the sound on your devices, moving away from loud noise, or using earplugs or other ear protection.
Earwax or fluid buildup can also cause hearing loss by blocking sounds that are carried from the eardrum to the inner ear. If wax blockage is a problem, your doctor may suggest mild treatments to soften earwax.
A ruptured eardrum can also cause hearing loss. The eardrum can be damaged by infection, pressure, or putting objects in the ear, including cotton-tipped swabs. See your doctor if you have ear pain or fluid draining from an ear.
Health conditions common in older people, such as diabetes or high blood pressure, can contribute to hearing loss. Ear infections caused by viruses and bacteria (also known as otitis media), a heart condition, stroke, brain injury, or a tumor may also affect your hearing.
Hearing loss can also result from taking certain medications that can damage the inner ear, sometimes permanently. These medications may be used to treat serious infections, cancer, or heart disease. They also include some antibiotics, and even aspirin at some dosages. If you notice a problem while taking a medication, check with your doctor.
Genetic variations can cause hearing loss as well. Not all inherited forms of hearing loss are evident at birth. Some forms can show up later in life. For example, otosclerosis, which is thought to be a hereditary disease, involves the abnormal growth of bone that prevents structures within the ear from working properly.
Health effects of hearing loss
Hearing loss can affect cognitive health. Studies have shown that older adults with hearing loss have a greater risk of developing dementia than older adults with normal hearing. Cognitive abilities (including memory and concentration) decline faster in older adults with hearing loss than in older adults with normal hearing. A recent analysis of several studies found that people who used hearing restorative devices (such as hearing aids and cochlear implants) had a lower risk of long-term cognitive decline compared to people with uncorrected hearing loss.
Older people who can’t hear well may become depressed or withdrawn from others because they feel frustrated or embarrassed about not understanding what is being said. Sometimes, older people are mistakenly thought to be confused, unresponsive, or uncooperative because they don’t hear well. These circumstances can lead to social isolation and loneliness.
Hearing loss, even small amounts, is also linked to an increased risk for falls. It also can affect public as well as personal safety, such as the ability to drive safely, when warning sounds are harder to hear.
How to cope with hearing loss
If you notice signs of hearing loss, talk with your doctor. If you have trouble hearing, you should:
- Let your family and friends know you have a hearing problem.
- Ask people to face you and to speak louder and more clearly. Ask them to repeat themselves or reword what they're saying.
- Pay attention to what is being said and to facial expressions or gestures.
- Let the person talking know if you do not understand what was said.
- Find a good location to listen. Place yourself between the speaker and sources of noise or look for quieter places to talk.
The most important thing you can do if you think you have a hearing problem is to seek professional advice. Your family doctor may be able to diagnose and treat your hearing problem. Or your doctor may refer you to other experts, like an otolaryngologist (ear, nose, and throat doctor) or an audiologist (health professional who can identify and measure hearing loss).
Devices to help with hearing loss
Many types of assistive devices are available to help people with hearing loss. These devices can amplify sounds, provide alerts, and help you communicate with others. For example, alert systems work with doorbells, smoke detectors, and alarm clocks to send visual signals or vibrations. Devices that use keyboards, touch screens, or text-to-speech technology can help you give and receive information more effectively. Learn more about the wide range of assistive devices available for people with hearing loss from the National Institute on Deafness and Other Communication Disorders.
Hearing aids are electronic, battery-run assistive devices that make some sounds louder. There are two main ways to get a hearing aid: by prescription or over the counter.
- An audiologist or hearing aid specialist can prescribe hearing aids for people with significant or complicated hearing loss. Prescription hearing aids require a medical exam, and then the health care professional will fit and adjust the device.
- Hearing aids have recently become available without a prescription. Over-the-counter hearing aids, which are sold in stores and online, may help people with mild to moderate hearing loss.
Before buying a hearing aid, find out if your health insurance will cover part of the cost.
A cochlear implant is a different type of assistive device that can help people who are profoundly deaf or hard of hearing. Whereas hearing aids make sound louder so damaged ears can hear it, cochlear implants create electric signals that the brain recognizes as sound. The implant requires surgical placement and hearing therapy.
If you are experiencing hearing loss, talk with your doctor about assistive devices that may be available to help.
How to talk with someone who has hearing loss
Here are some tips you can use when talking with someone who has a hearing problem:
- In a group, make a point to include people with hearing loss in the conversation.
- Find a quiet place to talk to help reduce background noise, especially in restaurants and at social gatherings.
- Stand in good lighting and use facial expressions or gestures to give clues.
- Face the person and speak clearly. Maintain eye contact.
- Speak a little louder than normal, but don’t shout.
- Try to speak naturally and at a reasonable speed.
- Do not hide your mouth, eat, or chew gum while speaking.
- Repeat yourself if necessary, using different words.
- Try to make sure only one person talks at a time.
- Be patient. People with hearing loss may also be frustrated by their condition. Stay positive and relaxed.
- Ask how you can help.
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For more information
National Institute on Deafness and Other Communication Disorders
American Speech-Language-Hearing Association
American Tinnitus Association
Hearing Loss Association of America
This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.
January 19, 2023