
Age-related hearing loss (presbycusis) is the most common cause of hearing loss worldwide.1 From communication issues to an increased risk of dementia, age-related hearing loss can significantly impact everyday life.
In this guide, we provide a detailed overview of age-related hearing loss, including the symptoms, causes, risk factors, and treatment options.
Jump ahead:
What Is Age-Related Hearing Loss? (Presbycusis)
Age-related hearing loss, also known as presbycusis, is a condition that typically develops gradually as a natural part of the aging process.
It is the most common type of hearing loss, affecting 1 in 3 adults in the United States between the ages of 65 and 74, and nearly 50% of all adults over the age of 75.1
Age-related hearing loss can affect communication, daily life, mental health, and even increase the risk of dementia in older adults.2
Because age-related hearing loss develops gradually, many people do not notice the symptoms at first.
Symptoms of Age-Related Hearing Loss
Here are some of the most common signs of age-related hearing loss to look out for:
- Tinnitus (ringing in the ears)
- Frequently asking others to repeat themselves
- Other people’s voices sound slurred or mumbled
- Turning up the volume to levels uncomfortable for others
- Trouble understanding speech, especially in noisy environments
- Trouble hearing high-pitched sounds, including:
- Certain consonant sounds like “f”, “k”, “s”, “p”, and “ch” 4
- Women’s and/or children’s voices
- Other higher-frequency sounds
If you or a loved one is experiencing any of these symptoms or any other hearing changes, schedule a hearing exam as soon as possible.
Causes of Age-Related Hearing Loss
Age-related hearing loss is a type of sensorineural hearing loss (SNHL). Sensorineural hearing loss is caused by damage in the inner ear, including the auditory nerve and/or the delicate hair cells responsible for sound processing.
Depending on which parts of the inner ear are affected, age-related hearing loss can fall into several distinct categories:
- Sensory presbycusis: caused by the loss of hair cells in the inner ear that detect high-pitched sounds, leading to trouble hearing higher frequencies.
- Neural presbycusis: caused by the loss of nerve fibers in the cochlea, as well as spiral ganglion neurons, which help carry sound signals to the brain.
- Mechanical presbycusis (cochlear conductive): involves physical age-related changes to the inner ear that interfere with sound processing.
- Strial presbycusis: happens with the loss of stria vascularis cells, which balance inner ear fluid to keep your auditory system functioning properly.
- Mixed presbycusis: a combination of two or more of the above changes happening at the same time.
While hearing loss is a natural part of the aging process, decline can be accelerated or intensified by other factors.
Risk Factors for Hearing Loss in Older Adults
As the name suggests, age is the primary catalyst of age-related hearing loss, but additional risk factors can influence how severely it occurs and when. Below are just a few:
Genetic Factors
Genetics play a significant role in your hearing. In fact, experts believe that anywhere from 35-55% of age-related hearing loss has genetic influences.3
Researchers have also identified over 100 genes that play a role in hearing loss.4 One of the most common genes linked to age-related hearing loss is the GJB2 gene.
The GJB2 gene is responsible for making a protein called the gap junction protein (connexin 26). This protein is crucial to ensuring proper cochlear function, which is a part of the inner ear responsible for hearing.
Underlying Health Conditions
Hearing loss can be a symptom of certain underlying health conditions. These conditions can affect blood flow, nerve health, or cause inflammation in the ear, all of which affect your hearing.
Below are some common conditions that may increase your risk of developing age-related hearing loss:
- Diabetes
- High blood pressure (hypertension)
- Heart disease
- Autoimmune conditions
- Lyme disease
- Stroke
- Tumors (Acoustic Neuroma)
- Kidney disease
- Thyroid disorders
Managing these conditions and seeking proper treatment can reduce their impact and help preserve your hearing health as you age.
Ototoxic Medications
Some medications can have damaging effects on your hearing. This is called ototoxicity, or medicine-induced hearing loss.
This risk of medicine-induced hearing loss can become more prevalent as you age. This is due to increased reliance on medications in older adults, as well as a higher vulnerability to the effects:
- 90% of adults above age 65 take at least 1 prescription medication regularly, and 80% take 2 prescription medications regularly.5
- Our kidneys naturally lose efficiency as we age, making it harder for the body to flush out medications. This can make the effects of ototoxicity more severe.5
Exposure to Loud Noise
Exposure to loud noise is a significant risk factor that can influence both the severity and the onset of age-related hearing loss.6 Over time, repeated or prolonged exposure to loud sounds can damage the hair cells in the inner ear that are essential for detecting sound. Once these hair cells are damaged or destroyed, they do not regenerate, leading to permanent hearing loss.
When combined with the natural deterioration that occurs with age, noise-induced damage can accelerate the decline in a person’s hearing ability.
Lifestyle Factors
Lifestyle choices also play an important role in age-related hearing changes. Certain habits and behaviors have been shown to increase the risk of developing age-related hearing loss or make it worse over time:
- Lack of physical activity: Multiple studies have linked sedentary lifestyles to an increased risk of hearing loss in older adults.7
- Poor diet: Research shows that a diet lacking essential nutrients like vitamins, magnesium, zinc, iron, and omega-3 fatty acids can increase the risk of hearing loss.8
- Smoking cigarettes: People who smoke cigarettes and/or are exposed to second-hand smoke have an increased risk of hearing loss.9
Healthy lifestyle habits can help protect your hearing and support long-term hearing health and overall wellness.
Age-Related Hearing Loss Treatment Options
While age-related hearing loss is a permanent condition, prescription hearing aids can make a significant difference in both hearing ability and overall quality of life.
Hearing aids can reduce feelings of loneliness and isolation in older adults, as well as cognitive strain. In fact, hearing aid use has been found to reduce the rate of cognitive decline by almost 50% in older adults at high risk of dementia.2
If you or a loved one is experiencing any hearing changes, it is important to see a specialist as soon as possible. Timely diagnosis is crucial to identify the underlying cause and determine the best treatment option for your unique needs.
Schedule a Hearing Exam at an Audibel Clinic Near You
Age-related hearing loss is a natural part of aging, but certain risk factors can influence its onset and severity. While there is no cure, protecting your hearing and leading a balanced lifestyle can support long-term auditory health. Early detection of age-related hearing loss plays a crucial role in reducing the impact of the condition on your daily quality of life.
Don’t wait until it’s too late—find an Audibel hearing clinic near you today to get the hearing healthcare you deserve.
References
- Cheslock, M., & De Jesus, O. (2023, August 23). Presbycusis. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK559220/
- Huang, A. R., Jiang, K., Lin, F. R., Deal, J. A., & Reed, N. S. (2023). Hearing loss and dementia prevalence in older adults in the US. JAMA, 329(2), 171. https://doi.org/10.1001/jama.2022.20954
- Gates, G. A., Couropmitree, N. N., & Myers, R. H. (1999). Genetic Associations in Age-Related Hearing Thresholds. Archives of Otolaryngology – Head and Neck Surgery, 125(6), 654. https://doi.org/10.1001/archotol.125.6.654
- Shearer, A. E., Hildebrand, M. S., Odell, A. M., & Smith, R. J. (2025, April 3). Genetic hearing loss overview. GeneReviews® – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK1434/
- Joo, Y., Cruickshanks, K. J., Klein, B. E., Klein, R., Hong, O., & Wallhagen, M. (2018). Prevalence of ototoxic medication use among older adults in Beaver Dam, Wisconsin. Journal of the American Association of Nurse Practitioners, 30(1), 27–34. https://doi.org/10.1097/jxx.0000000000000011
- The Influence of Ageing on Noise-Induced Hearing loss: Noise and Health. (n.d.). LWW. https://journals.lww.com/nohe/fulltext/2003/05200/the_influence_of_ageing_on_noise_induced_hearing.5.aspx
- 3 studies link hearing loss with less physical activity among older adults. (2021). National Institute of Aging. https://www.nia.nih.gov/news/3-studies-link-hearing-loss-less-physical-activity-among-older-adults
- Healthy diets linked to lower risk of hearing loss in women. (2025, May 8). National Institutes of Health (NIH). https://www.nih.gov/news-events/nih-research-matters/healthy-diets-linked-lower-risk-hearing-loss-women
- Dawes, P., Cruickshanks, K. J., Moore, D. R., Edmondson-Jones, M., McCormack, A., Fortnum, H., & Munro, K. J. (2014). Cigarette smoking, passive smoking, alcohol consumption, and hearing loss. Journal of the Association for Research in Otolaryngology, 15(4), 663–674. https://doi.org/10.1007/s10162-014-0461-0
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