Say What? Age-Related Hearing Loss and the Importance of Treatment

By: Terri Lawson, LAPSW, Care Manager and Advocate


Age-related Hearing Loss

Age-related hearing loss, called Presbycusis, is common. Most of us gradually lose our ability to hear well as we age.  One in three adults in the U.S. age 65 to 69 and more than half of all adults over 70 experience hearing loss. Among adults age 20 – 69, men are more than twice as likely as women to have hearing loss.  Hearing loss is the third most prevalent chronic medical condition among older adults, after arthritis and hypertension. There is substantial evidence that hearing loss is linked to dementia.

As we age, we may lose the ability to hear higher pitched sounds (like some consonants and women’s and children’s voices), not hear as well in noisy settings, and have difficulty understanding others’ voices.  We often ignore or deny symptoms of hearing loss. “My wife won’t speak up; my neighbor mumbles; that restaurant is too noisy; the TV is NOT too loud!” Some people experience ringing in their ears, headaches, and dizziness.

There are many causes of hearing loss, including long-term exposure to noise, conditions such as high blood pressure and diabetes, certain medications, long-term smoking, and in rare cases, outer or middle-ear abnormalities.  Hearing loss in older people is most often a combination of age-related and noise-exposure causes, and it occurs in both ears. Age-related hearing loss can’t be prevented, but treatment with hearing aids and assisted listening devices can help older people with hearing loss stay socially engaged, reduce falls, and decrease mental fatigue.  

“So what if I can’t hear well?”

“Other people can talk louder”

“I don’t have to hear everything”

“That’s what the volume button is for”


“I hear what I want to hear.”

Even when we realize we don’t hear well, many of us delay or refuse to get treatment. Among adults aged 70 and older who could benefit from hearing aids, fewer than 30 percent have ever used them. It is estimated that the average person waits wait 7 to 10 years from the time they first notice poor hearing to get their hearing checked.  As treatment is delayed, the ability to hear often gets worse.

Reasons people don’t use hearing aids include stigma and embarrassment, the aids don’t fit well, or the aids don’t improve hearing as much as expected. Also, hearing aids, especially when new to the wearer, need some tweaking to function optimally.  The customer may not persist in getting hearing aids checked and adjusted as their hearing with aids changes or when problems arise. Hearing aids are expensive and not covered by Medicare.


Hearing Loss and Dementia

Three highly-regarded studies (The John Hopkins Study, The Health ABC Hearing Cohort Study, and The Lancet Commission on Dementia) have identified a link between hearing loss and dementia.  It is important to note that hearing loss doesn’t cause dementia, or vice-versa. Also, using hearing aids in old age does not reduce the risk of dementia.

According to Dr. Frank Lin of John Hopkins, hearing loss “may come with some serious long-term consequences to healthy brain functioning,” Factors that may connect hearing loss with dementia include: (1) the connection between hearing loss and social isolation, a known risk factor for cognitive decline; (2) listening effort may take too many resources from other brain functions like memory and thinking (cognitive load); and (3) there may be some common underlying brain processes that impact both hearing loss and dementia.  

Treating Hearing Loss  

Midlife is when hearing loss symptoms usually begin to appear.  Things to do for hearing health include:

  • Add a hearing test to your 50+ health care prevention list: colonoscopy, flu shot, shingles shot, hearing test!
  • When others complain about your hearing, believe them. Get a hearing test, and if they are wrong, you can brag about it.
  • If you need hearing aids, get them.
  • If you have hearing aids, take care of them.
  • If you have hearing aids, be persistent in getting follow up care.  

Hearing loss, though irreversible, is treatable.  Hearing is an important communication tool that affects our cognitive functioning, social interactions, safety, and personal security.  It not only affects how we communicate with others, but how others communicate with us. It is important to have our hearing checked and, if needed, treated, to improve our quality of life and reduce risks that lead to unhealthy aging.

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