Presbycusis
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What is presbycusis?
What are the symptoms of presbycusis?
What are the causes of presbycusis?
What can be done?
How is a hearing aid selected?
Communication tips
How does hearing work?
Where can I get additional information?

What is presbycusis?
Presbycusis is the loss of hearing that gradually occurs in most
individuals as they grow older. Hearing loss is a common disorder
associated with aging. About 30-35 percent of adults between the ages
of 65 and 75 years have a hearing loss. It is estimated that 40-50
percent of people 75 and older have a hearing loss.

The loss associated with presbycusis is usually greater for high-
pitched sounds. For example, it may be difficult for someone to hear
the nearby chirping of a bird or the ringing of a telephone. However,
the same person may be able to hear clearly the low-pitched sound of
a truck rumbling down the street.

There are many causes of presbycusis. Most commonly it arises from
changes in the inner ear of a person as he or she ages, but
presbycusis can also result from changes in the middle ear or from
complex changes along the nerve pathways leading to the brain.
Presbycusis most often occurs in both ears, affecting them equally.
Because the process of loss is gradual, people who have presbycusis
may not realize that their hearing is diminishing.

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What are the symptoms of presbycusis?
With presbycusis, sounds often seem less clear and lower in volume.
This contributes to difficulty hearing and understanding speech.
Individuals with presbycusis may experience several of the following:

The speech of others seems mumbled or slurred.

High-pitched sounds such as "s" and "th" are difficult to hear and
tell apart.

Conversations are difficult to understand, especially when there is
background noise.

A man's voice is easier to hear than the higher pitches of a woman's
voice.

Certain sounds seem annoying or overly loud.

Tinnitus (a ringing, roaring, or hissing sound in one or both ears)
may also occur.
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What are the causes of presbycusis?
Sensorineural hearing loss is caused by disorders of the inner ear or
auditory nerve. Presbycusis is usually a sensorineural hearing
disorder. It is most commonly caused by gradual changes in the inner
ear. The cumulative effects of repeated exposure to daily traffic
sounds or construction work, noisy offices, equipment that produces
noise, and loud music can cause sensorineural hearing loss.
Sensorineural hearing loss is most often due to a loss of hair cells
(sensory receptors in the inner ear). This can occur as a result of
hereditary factors as well as aging, various health conditions, and
side effects of some medicines (aspirin and certain antibiotics).

Image of the inner ear

larger image
Presbycusis may be caused by changes in the blood supply to the ear
because of heart disease, high blood pressure, vascular (pertaining
to blood vessels) conditions caused by diabetes, or other circulatory
problems. The loss may be mild, moderate, or severe.

Sometimes presbycusis is a conductive hearing disorder, meaning the
loss of sound sensitivity is caused by abnormalities of the outer ear
and/or middle ear. Such abnormalities may include reduced function of
the tympanic membrane (the eardrum) or reduced function of the three
tiny bones in the middle ear that carry sound waves from the tympanic
membraine to the inner ear.