Hearing Loss In Old Age

Do you have difficulty hearing the high-pitched ringing of the phone or the chime of the doorbell or the beeping of a car? Or do you find yourself pressing the volume button to increase the sound of your cell phone, tablet, computer or TV set?

Or you might start to confuse words with the same sound such as feet and beet and need to speak louder to hear properly. Most likely you’re suffering from hearing loss which at first you might not notice at all and this may start early in your 30s and progressively towards your 60s.

Presbycusis is the most common type of age-related hearing loss and occurs as you grow older. It is a sensorineural hearing disorder which caused by the changes in the structure of the inner ear, middle ear and nerve pathways to the brain as the auditory system ages naturally.

Generally, it is caused by degeneration of the cochlea or the loss of the hair cells in cochlea. It affects progressively high frequencies sound at first and gradually the lower frequencies become indistinct, most often for both ears. However, aside from aging, there are other factors which cause hearing loss:

  • Genetics
  • Health conditions such as heart disease and diabetes
  • Over-dosage and side effects of medications such as aspirin and antibiotics
  • Constant exposure to loud noises such as music and work related noise from machinery and equipment

There are four pathological phenotypes of presbycusis:

  • Sensory presbycusis is the deterioration of the Corti or specifically the loss of the outer hair cells in the Corti.
  • Neural presbycusis is the atrophy of the spiral ganglion, the group of nerve cells in the cochlea and auditory pathways to the brain.
  • Strial or metabolic presbycusis is the degeneration of stria vascularis located in the outer wall of the cochlea.
  • Cochlear conductive presbycusis is the irreversible degeneration such as the thickening and stiffening of the basilar membrane of the cochlea.


There are devices which can help you and commonly used are hearing aids. These are medical devices you wear behind or in the ear to improve hearing by making the sound louder and audible. There are several types:

  • Behind-the-ear or BTE
  • In-the-ear or ITE
  • In-the canal or ITC
  • Completely-in-canal or CIC


Hearing aids have 3 basic parts: a microphone, amplifier and speaker. You may try all these types to find out which one works for you and you’re comfortable wearing. You need to learn how to put on and remove afterwards, adjust the volume level and charge the batteries. These electronic instruments can help you improve communication and to participate in daily activities more fully.


Another instruments which can help you are assistive listening devices such as amplified telephones and cell phones. Decibels requirements for different levels of hearing loss are:

  • mild hearing loss – 18-28 dB
  • moderate hearing loss – 30-48 dB
  • severe hearing loss – 50-55 dB


Choose phones with the best features such as adjustable volume control, hearing aid compatible, visual call indicators, headphone compatible and visual message indicator.  You need to make sure your hearing aid and phone are compatible to get the best from both these devices. For more info check out this section.

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