What is presbycusis?

Presbycusis is the gradual loss of hearing in both ears that occurs as you age. It can be affected by the loss of hair cells, various health conditions, and certain medications or antibiotics. Because presbycusis is such a gradual change, some people are not aware that they have it at first. This type of hearing loss usually affects your ability to hear high-pitched sounds rather than low-pitched sounds. Other common signs of presbycusis include difficulty to understand conversations and tinnitus.

There are three main types of hearing loss

Different types of hearing loss can arise for a number of reasons. Presbycusis occurs naturally due to changes in the ear and this can be linked to other health conditions. However, environmental factors can also damage hearing and impact people of all ages. Excessive sound exposure is a leading cause of noise-induced hearing loss (NIHL), which is permanent. In fact, according to hearing loss statistics from the National Institute on Deafness and Other Communication Disorders, up to 17% of people between ages 12 and 19 have some level of hearing loss due to noise exposure.*

There’s nothing wrong with turning up the volume now and then to enjoy concerts, movies and social events, as long as you’re using hearing protection when needed. But prolonged exposure to noise that is too loud can become problematic, and short exposure to extreme sound levels can do the same. These brief but harmful sounds include explosions like fireworks, or sirens. Even everyday tools like lawn mowers and leaf blowers can lead to hearing loss over time. Sounds at 85 decibels or above (think food blenders and motorcycles) can put you at risk without ear protection, which plays an essential role in preventing hearing loss.

If you’re a music-lover, be conscious of the volume on your earbuds and speakers, especially if playing music is part of your daily routine. Any noise at 70 decibels or below is considered safe, even with regular exposure. This sound level is within the range of normal conversation. Headphones have the potential to be cranked all the way up to a maximum of around 100 decibels, which is unsafe to listen to over a long period of time. Since concerts can also fall into this decibel range, ear plugs are a must.

Signs of hearing loss to pay attention to

If you’ve ever caught yourself saying “what?” more than once, you may have dismissed it as situational. But this can actually be a common early sign of presbycusis and may be the first signal that it’s time to get your hearing checked. Remember that hearing loss can affect anyone, regardless of whether they’re a child, teen or adult. If you’re wondering how to tell if you have hearing loss, here are a few early symptoms to look out for.

Benefits of a hearing exam

If these seemingly minor signs of hearing loss don’t seem like a big deal, take a step back to consider all the ways hearing health affects your life. From conversing with loved ones to hearing birds chirping outside while walking through your neighborhood, sound makes life feel complete. To preserve the hearing you have, it’s a good idea to consult a professional for a hearing exam and seek treatment if you notice hearing loss symptoms.

There are plenty of hearing facts and myths out there, and being aware of them can make a positive difference. For example, missing out on everyday sounds for a long period of time can lead to other challenges like social isolation and difficulty processing sound. Using hearing aids has also been shown to help relieve these issues, allowing wearers to stay connected to others and continue living their daily life with confidence. This is why it’s so important to consider the solutions available.

When thinking about how to check for signs of presbycusis and preserve the hearing you have, scheduling hearing exams is a key step. This is an opportunity to speak with a professional and have them monitor your overall health in each ear. If you’re under age 60 and have healthy hearing with no symptoms of hearing loss, schedule a test every three to five years. If you’re 60 or older, it’s recommended to get your hearing tested yearly to monitor for age-related hearing loss. If you’re experiencing any hearing changes or noticeable symptoms of hearing loss, book an appointment to speak with a professional and find out more.

Other hearing impairments in older adults

Presbycusis is not the only hearing issue linked to aging. Other age-related hearing conditions include tinnitus, a persistent ringing or buzzing in the ears that often accompanies hearing loss. Older adults may also experience auditory processing disorder (APD), where the brain has difficulty interpreting sounds even when hearing ability appears normal. This can make it especially hard to understand speech in noisy environments.

In some cases, otosclerosis can progress with age and lead to additional hearing issues. Age-related changes in the auditory nerve or middle ear bones may also contribute to declining hearing ability.

Certain risk factors can accelerate these conditions, including genetics, prolonged exposure to loud noise, smoking, and chronic health conditions like diabetes and hypertension. Combined, these factors increase the likelihood of developing hearing impairment in old age, making regular hearing checks an important part of healthy aging.

What age does presbycusis usually start?

Normal age-related hearing loss often begins around the age of 65, although signs can appear much earlier. In fact, a 2011 study found that over 20% of adults aged 48 to 59 were already experiencing symptoms of this gradual decline in hearing. According to the National Institute on Aging, around one in three adults between the ages of 65 and 74 lives with some degree of age-related hearing loss. This proportion increases significantly with age—affecting roughly half of adults over 75, and up to 90% of people aged 80 and above.

This type of hearing impairment in older-individuals is extremely common and tends to worsen over time. While it is often considered a normal part of aging, it can have a serious impact on communication, social engagement, and overall quality of life if left unaddressed.

How to prevent hearing loss in older age?

While some hearing loss is a natural part of aging, there are steps you can take to reduce the risk or slow its progression. Prevention starts early, but it’s never too late to adopt habits that support lifelong hearing health. One of the most important strategies is avoiding prolonged exposure to loud noise. If you're regularly in noisy environments—whether at work, concerts, or using power tools—wearing hearing protection like earplugs or noise-cancelling earmuffs can help prevent damage. At home, keep the volume at a safe level when using headphones or watching TV.

Maintaining overall health also plays a role. Chronic conditions such as high blood pressure, diabetes, and smoking are all linked to a higher risk of hearing loss. Managing these conditions through a healthy diet, regular exercise, and routine check-ups supports both your hearing and general well-being.

Regular hearing tests are vital, especially after the age of 60. Early detection allows for timely intervention, which can prevent further deterioration and improve quality of life. Miracle-Ear offers free hearing tests at every location, making it easier than ever to keep track of your hearing health.

While some degree of hearing loss in older populations is natural, these preventive steps can help preserve hearing for as long as possible. It's never too late to start taking care of your ears.

Hearing aids for age related hearing loss and other treatments

Presbycusis, or age-related hearing loss, is a gradual condition that affects many older adults. While it cannot be reversed, several presbycusis treatment options can significantly improve hearing and quality of life.

The most common and effective treatment is hearing aids. These small electronic devices amplify sound, making it easier to understand speech and engage in conversations. Modern hearing aids are discreet, comfortable, and can be customized to match an individual’s level of hearing loss and lifestyle needs.

For those with more advanced hearing loss or who do not benefit from traditional hearing aids, other solutions such as cochlear implants or bone-anchored hearing systems may be considered. These options are typically recommended by hearing care professionals after a thorough hearing assessment.

In addition to devices, presbycusis treatment may include strategies such as lip reading, auditory training, and communication techniques to support better understanding in noisy environments. Treating underlying health conditions like diabetes or cardiovascular disease can also help slow the progression of hearing loss.

Early intervention is key. If you or a loved one is experiencing age-related hearing changes, consult a Miracle-Ear hearing care professional to explore the best treatment options and stay connected to the world around you.

Is presbycusis sensorineural or conductive?

Presbycusis, or age-related hearing loss, is classified as a sensorineural type of hearing loss. This means it results from damage to the inner ear (cochlea) or the auditory nerve pathways that carry sound signals to the brain. It is not conductive, which involves problems in the outer or middle ear that block sound from reaching the inner ear. As we age, the tiny hair cells in the cochlea—which help convert sound vibrations into electrical signals—gradually deteriorate. Once damaged, these hair cells do not regenerate, leading to permanent hearing loss. In some cases, presbycusis also involves changes in the auditory nerve, making it harder for the brain to process sounds, especially speech.

Presbycusis typically affects both ears equally and progresses slowly over time. People often notice difficulty hearing high-pitched sounds or following conversations in noisy environments. Because the damage occurs within the sensory and neural components of the hearing system, hearing aids or other assistive devices are usually recommended to manage symptoms. Understanding that presbycusis is sensorineural helps guide appropriate treatment. Early hearing tests and consultations with hearing care specialists are essential to determine the type and severity of hearing loss and to find the best ways to maintain communication and quality of life.

Most common early signs of hearing loss in adults

If your hearing has started to decline, some early signs and symptoms of hearing loss in adults may include frequently asking others to repeat themselves, increasing the volume on the television or radio, or struggling to follow conversations—especially in noisy or crowded environments. You might also find it harder to hear higher-pitched voices, such as those of women and children, and have difficulty distinguishing certain consonant sounds like S, T, K, P, B, and F.

In many cases, friends and family notice changes before you do. They may point out that you're not responding during conversations or that the volume on your devices is too loud. If this sounds familiar, it could be time for a hearing  test.

Less obvious signs and symptoms of hearing loss in adults can include behaviors or physical sensations that seem unrelated to your ears. You might avoid social situations with background noise, feel mentally exhausted after long conversations, experience ringing in the ears (tinnitus), or even notice issues with balance or dizziness.

Recognizing these symptoms early on can lead to effective interventions that help you stay connected and maintain a better quality of life.

Why is detecting hearing loss symptoms important?

While some changes that come with aging can be accepted, hearing loss is not one of them. It’s important to recognize and address hearing issues early, as the effects go far beyond missing a few words—impacting your safety, social life, and overall health in ways that may not be immediately obvious.

• Quality of Life

When hearing becomes difficult, activities that once brought joy—like socializing visiting with friends or family—can start to feel exhausting. Repeatedly asking others to speak up or say things again can feel frustrating or embarrassing, leading many to simply nod along rather than admit they didn’t hear. This can cause misunderstandings or even damage relationships if it seems you’ve forgotten something important

• Missing Critical Information

Nodding without understanding becomes especially risky in medical settings, where you could miss vital health instructions. Everyday safety is also compromised—you may not hear someone warn you about a hazard, or a cyclist approaching from behind. Hearing loss can also prevent you from detecting crucial alarms, such as smoke or carbon monoxide detectors, fire alarms, or car horns.

• Broader Health Impacts of Untreated Age-Related Hearing Loss

Untreated hearing loss has been linked to increased stress, anxiety, and fatigue. Over time, it can contribute to:

• Social isolation: Avoidance of interactions due to difficulty hearing
• Depression: A greater risk in older adults with hearing loss
• Cognitive decline: Studies suggest a link between hearing loss and dementia
• Falls: Hearing-impaired individuals are more prone to serious falls

Recognizing and treating hearing loss early can help preserve not only your hearing, but your overall well-being.