A Guide to Age-Related Hearing Loss

What Is Age-Related Hearing Loss?

Age-related hearing loss, also called presbycusis, is the gradual loss of hearing that can happen as we get older. It usually affects both ears and develops slowly, so you may not notice the changes right away.

Age-related hearing loss often affects high-pitched sounds first, making it harder to hear certain voices or distinguish words in conversation. It is the most common type of hearing loss and affects an estimated two-thirds of Americans over age 70.2

Age-related hearing loss doesn’t mean you’re going deaf. Many people with hearing loss can continue to communicate and enjoy everyday activities with the right support. Recognizing changes in your hearing and addressing them early can make it easier to stay connected and maintain your quality of life.

What Causes It?

Age-related hearing loss usually doesn’t have a single cause. For many older adults, it develops from a combination of factors that build up over time. Here are some of the most common causes.

The Natural Aging Process

Your inner ear contains thousands of tiny hair cells that help turn sound vibrations into signals your brain can understand. Over time, these hair cells can become damaged or wear down. Unlike many other cells in the body, they don’t repair themselves or grow back. This natural wear and tear is one of the main reasons hearing loss becomes more common with age.3

A Lifetime of Noise Exposure

Repeated exposure to loud sounds can damage the hair cells in your inner ear. Working around machinery, using power tools, or listening to loud music over many years can all contribute to hearing loss. Some older adults may have spent years in noisy workplaces before hearing protection was widely used or required. In fact, an estimated 40 million adults in the U.S. may have hearing loss tied to noise exposure.4

Health Conditions and Medications

Some health conditions, including heart disease, high blood pressure, and diabetes, may be linked to hearing loss. Certain medications can also affect hearing. These include some chemotherapy drugs, high doses of aspirin, and certain antibiotics.

If you’re concerned that a medication may be affecting your hearing, talk with your doctor before making any changes to your treatment.

Genetics

Your genes may also contribute to age-related hearing loss. Research suggests that genetics may play a role in age-related hearing loss between 35% and 55% of the time.5

If a parent or sibling experienced significant hearing loss, you may have a higher risk as well. However, genetics is only one piece of the picture. Noise exposure, health conditions, medications, and other factors can also influence how hearing changes over time.

Warning Signs to Watch For

Because age-related hearing loss often develops gradually, you may adjust to changes in your hearing without realizing it. You might start speaking louder, sitting closer to the TV, or leaning in when someone is talking. By the time hearing loss becomes noticeable, it may have been developing for several years.

Common signs of hearing loss include:

• Frequently asking people to repeat themselves
• Turning up the volume on the TV, radio, or phone
• Having trouble following conversations in noisy places
• Difficulty hearing high-pitched sounds, such as children’s voices, doorbells, or birds
• Hearing ringing in your ears, known as tinnitus
• Feeling unusually tired after conversations because of the effort required to listen
• Avoiding social activities because it’s difficult to follow conversations

One of the early signs can be having trouble hearing in noisy environments while hearing relatively well in quiet settings. If you can easily follow a one-on-one conversation at home but struggle to understand people at restaurants or group gatherings, it may be worth having your hearing checked.

Why Treating It Matters

Many older adults put off addressing hearing loss, sometimes for years. It may not seem urgent, especially when the changes happen gradually. But untreated hearing loss can affect more than your ability to hear.

Hearing Loss and Health Risks

Research has linked untreated hearing loss with a higher risk of dementia. One study found that each 10-decibel increase in hearing loss severity was associated with a 16% higher risk of dementia.6  Hearing loss can also contribute to social isolation and depression when social activities become harder to follow.

Hearing loss may also be connected to other health risks. Regular hearing aid use has been associated with a 24% lower risk of early death. Research has also found a connection between hearing loss and falls, with even mild hearing loss associated with a higher risk of falling.7 These findings don't mean hearing loss will cause dementia, depression, falls, or other health problems. However, they do show why it's worth taking changes in your hearing seriously.

Treatment isn't only about hearing conversations more clearly. Hearing aids, assistive listening devices, and other options can make it easier to communicate, participate in social activities, and stay connected with the people around you. If you notice changes in your hearing, getting a hearing evaluation is a good place to start.

Hearing Loss Treatments

The right treatment for hearing loss depends on how much your hearing has changed and your lifestyle. Here’s a look at what’s available:

* Costs are approximate and vary by provider and location. Original Medicare (Parts A and B) does not cover hearing aids. Many Medicare Advantage (Part C) plans offer partial benefits. All hearing aids are HSA and FSA eligible.

For mild-to-moderate hearing loss, OTC hearing aids are a great place to start. Since the FDA established the OTC hearing aid category in 2022, adults can purchase these devices directly without a prescription or audiologist visit.8 OTC hearing aids also typically cost less than prescription models. Many include features such as AI-powered noise reduction, Bluetooth streaming, and smartphone app customization.

If your hearing loss is more significant, or you'd prefer professional guidance, try prescription hearing aids. And if you're dealing with severe to profound hearing loss, a cochlear implant may be worth considering. Medicare Part B covers cochlear implants as long as they meet Medicare's medical-necessity requirements.

Top OTC Pick: ELEHEAR

ELEHEAR's Delight model offers a discreet earbud-style.

For older adults with mild to moderate hearing loss who are considering over-the-counter, ELEHEAR offers several models at different price points.

The company’s flagship model, the ELEHEAR Beyond Pro, costs $599 per pair and uses VOCCLEAR® 2.0 AI to improve speech clarity in noisy environments. This can be especially helpful in situations, like family gatherings, restaurants, and phone calls.

ELEHEAR also offers more affordable options, including the Beyond at $399 and the Delight at $369. All three models include a 45-day return period and access to remote audiologist support, allowing you to try the hearing aids at home before deciding whether they’re right for you.

Tips for Caregivers

If you’re an adult child, spouse, or close friend of someone experiencing hearing loss, your support can make a meaningful difference. You can encourage your loved one to seek help while also making everyday conversations easier.

How to Bring It Up

Choose a calm, private time to talk. Focus on staying connected rather than criticizing their hearing. Saying, “I miss being able to chat easily” may feel less confrontational than telling someone they need to get their hearing checked.

It’s also common for people to be hesitant about addressing hearing loss. Be patient and avoid pushing the issue. A gentle observation may be enough to start the conversation and give your loved one time to consider getting help.

How to Help Day-to-Day

Small changes can make conversations easier:

• Face your loved one when speaking so they can see your face and follow the conversation.
• Reduce background noise.
• Speak clearly at a normal pace. Shouting can make speech harder to understand.
• If your loved one misses something, try rephrasing it instead of repeating the same words.

If your loved one has recently started wearing hearing aids, give them time to adjust. The first few weeks may feel unfamiliar or frustrating as they get used to new sounds and sensations. Encouragement and patience during this adjustment period can help them stick with their hearing aids long enough to become comfortable using them.

Protecting the Hearing You Have

Age-related hearing loss cannot be reversed, but healthy habits may help protect the hearing you have and reduce your risk of further hearing damage. Here are habits that make a difference:

• Protect your ears from loud sounds. Wear hearing protection during activities that are louder than a busy restaurant, such as concerts, sporting events, or when using loud equipment.
• Keep headphone volume at 60% or lower. Taking regular breaks from headphones can also help reduce your exposure to loud sounds.
• Manage your overall health. Keeping blood pressure, cholesterol, and blood sugar within healthy ranges may support your overall hearing health.
• Review your medications. Ask your doctor or pharmacist whether any of your medications have ototoxic, or hearing-affecting, side effects. Don't stop taking a medication without medical guidance.
• Wear your hearing aids consistently. If you use hearing aids, wearing them as recommended can help you get the most benefit from them.
• Schedule regular hearing checks. Routine hearing tests can help identify changes early and give you and your health care provider an opportunity to discuss treatment options.

Conclusion

Age-related hearing loss is common, but it doesn’t have to interfere with the conversations, relationships, and activities that matter most. Recognizing the early signs and understanding your treatment options can help you take action sooner. Today’s hearing technology is more accessible and affordable, with options for different levels of hearing loss and budgets.

If you’ve noticed changes in your hearing, consider taking a hearing test and talking with your doctor or hearing care professional. Getting the right support can help you improve your day-to-day quality of life.