Presbycusis is the gradual and persistent loss of hearing in both ears that is related to aging. The effects increase over time and are linked to genetic and environmental factors.

Presbycusis affects around 1 in 3 adults in the United States between 65 and 74 years of age and is one of the most common causes of hearing loss in older adults. One of the leading causes of presbycusis is long-term exposure to noise, and it typically results in an inability to hear high-pitched sounds.

Human hearing is a result of sound waves being turned into electrical signals. This process depends on delicate hair cells vibrating in the inner ear. Noise and other factors can damage these hair cells and, once gone, they never grow back, resulting in irreversible hearing impairment.

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Whilst presbycusis is mainly a result of the body aging, it may also be caused by genetic or environmental factors

Presbycusis may be caused, or made worse, by environmental and genetic factors, other diseases, and certain medication types.


Exposure to loud music or noise in the workplace, such as traffic or construction noise, are leading environmental causes of presbycusis.

Other loud environmental sounds include lawn mowers, firearms, leaf-blowers, and other loud tools and appliances.

Genetic factors

Genetic factors can cause some people to develop this kind of ear damage, and they may experience problems with their hearing as they age.

Other diseases

Other conditions that can cause presbycusis, include:

These illnesses can affect hearing because the essential hair cells depend on a good blood supply.


Some drug treatments, including some antibiotics, aspirin, and chemotherapy have a toxic effect on the ear and nerve supply. These medicines may cause presbycusis as a result.

Presbycusis typically affects a person’s ability to hear high-pitched sounds. As the condition progresses, people may find it difficult to hear what others are saying, particularly in noisy places.

These symptoms can make social interactions challenging. As a result, a person with presbycusis may find their quality of life deteriorates, and they may also experience social isolation, depression, and lower self-esteem.

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Continual exposure to loud noises, for example when working in the construction industry, may potentially cause presbycusis.

Avoiding noise and other risk factors from an early age can help prevent damage to the hair cells in the inner ear, which can minimize the effects of presbycusis later on in life.

Managing illnesses such as such as diabetes, high blood pressure, and heart disease may improve circulation and minimize symptoms linked with presbycusis.

Avoiding medications that are toxic to the ear, such as some antibiotics and aspirin, can also be helpful in preventing or lessening the side effects linked with presbycusis. However, doing so may not always be possible. People should always speak with a doctor before they stop taking any medication.

A doctor will likely suspect presbycusis if an older adult experiences gradual hearing loss in both ears.

Before diagnosing presbycusis, a doctor will first rule out other causes of hearing loss by checking the eardrum for damage and the ear canal for blockages. The doctor will also look out for signs of inflammation and infection in the ear.

If further investigation is needed, the doctor will usually refer the person to a hearing specialist called an audiologist.

An audiologist can test a person’s hearing by asking them to respond to sounds played to one ear at a time through headphones. This test, called an audiogram, will establish whether or not the person can hear specific tones and will usually indicate whether a person has presbycusis.

Successful treatment for presbycusis usually takes time and requires patience. An approach that involves specialists from different areas of healthcare can be beneficial.

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Hearing aids are discrete devices that can improve hearing, especially in places where there is a lot of noise.

People who could help in developing and administering an effective, personalized treatment plan include experts in:

  • otolaryngology (ear, nose, and throat)
  • audiology
  • neurology
  • psychology

Many people with presbycusis seek treatment after a few years, once the symptoms have already progressed. People may not be aware of the extent of their hearing loss because it happens gradually.

Also, hearing loss is often considered to be inevitable. Some people do not know that presbycusis can be treated. Others are reluctant to use a hearing aid because of what other people will think of them. In some cases, people only seek treatment if family members insist.

There are no approved drugs that can restore hearing loss due to presbycusis. The effects of age-related hearing loss on daily life can be successfully lessened with symptom management and, in severe cases, with surgery.

Treatment options may include the following:

Management techniques

People who have difficulty hearing will usually rely more on visual cues. This can include lip reading and interpreting posture and gestures. In severe cases, it can include sign language.

It is usually helpful to face a person directly when talking to them. Avoiding noisy situations and ensuring adequate lighting can make it easier to take part in conversations with confidence.

Telling family and friends about hearing problems, and asking them to communicate in helpful ways, can go a long way toward making life easier for a person who has difficulty hearing.

Assistive listening devices

Hearing aids can be useful for people who find it hard to hear in noisy situations. A hearing aid is an electronic device that is worn inside or behind the ear.

The device has a microphone, an amplifier, and a speaker. The microphone receives the sound, the amplifier magnifies the sound, and the speaker relays it to the ear.

A hearing loop is a sound system typically used in public places. It provides a magnetic, wireless signal that can be received by a person using a hearing aid.

Hearing loops are likely to be used for counter services, such as a post office, a shop, or in a bank. They can also be found in places of worship and classrooms.

Telephone amplifiers can be effective, as can devices that convert sound to text. Subtitles are frequently available for television and films.

Cochlear implants

Implants can restore hearing in those people who have severe hearing issues. An electrode array in the inner ear bypasses the damaged part of the ear known as the cochlea. Electrical signals directly stimulate the remaining nerve cells in the cochlea.

Most people with cochlear implants have significantly improved hearing, particularly if hearing aids are ineffective.

Presbycusis cannot be cured and there is no approved medication to manage it. As life expectancy increases, so too does the problem of age-related hearing loss.

Courses of treatment and symptom management techniques can greatly improve an individual’s quality of life. As well as helping with hearing, they can reduce feelings of isolation, social stress, depression, anxiety, and issues with self-esteem.

Presbycusis gets worse with time, and it is important that people get regular monitoring so that personalized treatment plans can be altered to suit their requirements as they change.