Presbycusis: Age-Related Hearing Loss
February 18, 2022

Hearing loss is something that can happen to people of all ages, but you may ask yourself why it is more common in older people than younger people. The answer has to do with presbycusis which is hearing loss that is linked with age.

Presbycusis has a number of different contributing factors, and understanding the things that lead to age-related hearing loss can enable one to try and prevent it. 

Below is a closer look at presbycusis, the factors that contribute to it, how it is treated, as well as ways you can protect your hearing. Understanding these aspects of age-related hearing loss can help to ensure that you are able to hear for many years to come. 

Factors of Age-Related Hearing Loss

Among adults between the ages of 20-69, those that are between the ages of 60-69 have the largest prevalence of hearing loss. This trend is something that occurs across the globe. While age is a strong predictor of hearing loss, it doesn't get to the underlying factors that contribute to an increased chance of a loss of hearing as you get older. 

Take a look at the factors that can lead to hearing loss as you age. Understanding these underlying factors is important for furthering your understanding of presbycusis and its potential causes.

Loud Noise Exposure

One of the largest contributing factors to age-related hearing loss is exposure to loud noises. Noises over 85 dB in loudness have the ability to potentially cause damage. The longer you live, the more likely you are to experience noises at or above this threshold. 

Some sounds over 85 dB include a loud concert, a motorcycle, and even heavy traffic background noise. More obvious loud sounds like that of a gunshot are able to cause noticeable damage in a relatively short time frame. Yet, other loud everyday sounds slowly start to impact hearing. The more time spent in these loud environments, the more likely hearing loss is to develop. 

The main mechanism of noise-induced hearing loss has to do with the inner ear and special fluid there. The inner ear has sensory hair cells that are used to detect sounds at different tones. When the specific tone is present, the corresponding sensory hair bends and sends a signal to the brain.

When a loud sound goes off, it can damage the sensory hair and make it less sensitive to noises. Over time this decreased sensitivity of sensory hairs leads to an inability to hear certain sounds at a lower volume. 


Genetics refers to the genes you inherit from your parents. Many of the physical traits you have are attributable to the genes that your parents passed down to you. The color of your hair, eyes, and skin are all largely determined by your parent's genes that were passed down to you. 

Another component of genetics is that you may inherit a predisposition to a certain disease or ailment like hearing loss. If you have a family history of age-induced hearing loss you may be at a greater risk for developing it as well. Keep an eye out for symptoms of age-related hearing loss.

Keeping this in mind can be incredibly helpful in ensuring you get more frequent hearing checks. Having a difficult time hearing can have a number of detrimental side effects on your quality of life, like social isolation. Ultimately, staying on top of hearing issues can ensure you get more timely, life-impacting care. 


Another factor that may contribute to your ability to hear as you get older is your lifestyle choices. Lifestyle choices include what you eat and the activities you do on a day-to-day basis.

Not eating a nutritious diet and having a lack of physical exercise constitutes a less than ideal lifestyle and could cause potential problems with your health in the long run. Having an unhealthy lifestyle is linked to a number of conditions such as diabetes, weight gain, and hypertension. For example, a 2013 study found a potential association between hypertension and the development of hearing loss.

A few years later, a 2017 study found a similar association between diabetes and the development of hearing loss. Having an unhealthy lifestyle for long enough can have detrimental impacts on your body and may even have the possibility of contributing to hearing loss as you get older. 

Additionally, having trouble hearing can lead to isolation and depression.

How Is Presbycusis Diagnosed?

Presbycusis can be caused by a number of different factors, but at the end of the day, they all lead to a decreased ability to hear. While common symptoms like not being able to hear certain sounds would seem like enough to diagnose hearing loss, there is a specific methodology utilized by a healthcare provider like your hearing specialist to diagnose hearing loss and determine its severity.

Below is a closer look at some of the things you could expect an audiologist to perform to evaluate your hearing and diagnose hearing loss.

Medical History

The first step an audiologist will typically take in a hearing exam is to take your family history. Your MD or audiologist will likely ask about any family members that have hearing issues to help determine if there are any underlying genetic risk factors they should know about. Heart disease and diabetes can sometimes be common causes of hearing loss. 

In addition to family history, they will likely ask you if you have had any notable loud noise exposure, what medications you have taken (overuse of Aspirin, for example), as well as what your occupation is. These factors can all help an audiologist to determine what kind of risk factors may be applicable to you. 

Visual Exam and Visual Cues

The next step in the diagnosis of hearing loss is to take a look into the inner and outer ear canal. There are a number of potential causes of a decreased ability to hear, and one that could occur is a buildup of earwax known as an earwax impaction.

Impacted earwax occurs when the buildup of wax becomes so great that it blocks the entrance of the ear canal, and the ear is unable to naturally remove it. Unlike true age-related sensorineural hearing loss, hearing loss due to an ear wax impaction is almost completely reversible by simply removing the blockage.

By utilizing a device known as an otoscope (a lighted scope), the audiologist is able to visualize the ear canal. They will make sure it is free of blockage like ear wax, as well as ensuring the other outer ear structures are okay. Other issues such as a torn or damaged eardrum may be a contributing factor to hearing loss. 


Tympanometry is another test that will likely be performed to help assess the proper functioning of the middle ear. The ear is composed of three major parts and includes the outer ear, the middle ear, and the inner ear.

The middle ear consists of the eardrum and the middle ear bones. The eardrum is at the innermost end of the ear canal and it vibrates in response to the sounds in your environment. The thin and slightly flexible nature of the eardrum allows it to effectively conduct sound to the inner ear. 

A tympanometry test is one that applies slight pressure to the eardrum and ensures it is functioning so that you can hear properly. Middle ear issues can contribute to hearing loss. Testing its proper functioning can help an audiologist to pinpoint the cause of a hearing issue. 


One of the best tools an audiologist has at their disposal is an audiometer which is the main device utilized to analyze hearing loss in a quantitative way. An audiometry test consists of playing a series of sounds through headphones and the patient raising their hand when they hear the sound. The sounds that are played cycle through a number of different tones and volumes.

By the end of an audiometry test, the audiologist will have a good idea of your hearing ability in each individual ear and what the quietest sound is that you can hear which is referred to as your hearing threshold. These values are the main determinant of whether or not you have hearing loss and the degree of hearing loss you have. 

Treatment and Assistive Devices

Depending on your specific case of hearing loss, your treatment options may differ. The vast majority of instances of presbycusis are a form of sensorineural hearing loss, which is a problem with the inner ear.

Unfortunately, there is not a cure for sensorineural hearing loss, but there are great options that can allow you to hear more sounds in your environment. Some people use ear plugs, ear muffs, telephone amplifiers, or work on speech-reading. 

When it comes to treatments for age-related sensorineural hearing loss, the go-to recommendation tends to be a type of hearing aid. Hearing aids are devices that take incoming sounds and amplify them to a volume that is within your hearing threshold. Hearing aids have traditionally cost patients a lot of money. Many prescription-grade hearing aids can cost thousands of dollars which isn’t feasible for most people. 

Audien is a hearing company that is changing the industry for the better by providing high-quality hearing aids at an approachable price. Options like the EV1 cost less than $100, allowing hearing aids to be more accessible than ever. 

Presbycusis and Hearing Loss

In summary, presbycusis is a term that refers to age-related hearing loss. There are a number of different potential factors that can contribute to the development of age-related hearing impairments which include exposure to loud noise, genetics, health conditions, and lifestyle (like smoking).

If you suspect hearing loss as you get older, schedule a hearing test with your local audiologist so they can assess your hearing and help you determine if hearing aids like the Audien Atom may be a good option for you. 


Quick Statistics About Hearing | NIDCD.

Effects of Hypertension on Hearing | NCBI

Probable Association of Hearing Loss, Hypertension and Diabetes Mellitus in the Elderly | NCBI

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Drew Sutton M.D.

Drew Sutton, MD is a board-certified otolaryngologist. He has extensive experience and training in sinus and respiratory diseases, ear and skull base surgery, and pulmonary disorders. He has served as a Clinical Instructor at Grady Hospital Emory University for more than 12 years.

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