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Hearing Loss in the Elderly

Thursday, January 27, 2022

Hearing loss is a common issue in the elderly. But because it happens gradually, hearing loss may easily go undiagnosed, potentially leading to isolation and depression. In this article, we look at the signs and causes of age-related hearing loss and explain different treatment options. 

What Are the Signs of Loss of Hearing in the Elderly?

Hearing loss is frequent among the elderly. According to the National Institute on Aging, 25% of people aged 65-74 and up to 50% of those older than 75 suffer from a disabling hearing loss.

Symptoms of age-related hearing loss typically include: 

  • Difficulty hearing high-pitched sounds, such as the voices of women or children
  • Difficulty hearing in places with noisy backgrounds like restaurants
  • Being unable to understand phone conversations
  • Straining to follow the conversation when people talk at the same time
  • Misunderstanding what people say
  • Trouble hearing consonants
  • Perceiving certain sounds as too loud
  • Muffling of speech and other sounds
  • Ringing in one or both ears.

Continue reading to learn more about the different types of hearing loss. 

Types of Hearing Loss

There are three main types of hearing loss: sensorineural, conductive, and mixed. 

Sensorineural hearing loss (SNHL)   

Sensorineural hearing loss is the most common type that accounts for more than 90% of hearing loss cases in adults. This type of hearing loss is permanent and due to damage to the auditory nerve or the inner ear. Common causes include the natural aging process, genetic factors, exposure to loud noises, and Meniere’s disease.

Conductive hearing loss    

Conductive hearing loss is caused by damage to the outer or middle ear that prevents sounds from reaching the inner ear. Causes may range from earwax buildup to ear infections, benign tumors, and a punctured eardrum. Conductive hearing loss is usually restored by medical treatment or surgery.

Mixed hearing loss

Hearing loss can result from a combination of two different types of hearing loss, for example, sensorineural hearing loss complicated by earwax buildup.

Other types of hearing loss include sudden hearing loss, tinnitus, and presbycusis.  

Sudden hearing loss  

Sudden hearing loss is a rapid loss of hearing of at least 30 decibels within 3 days. It usually affects only one ear. This hearing loss is considered a medical emergency, since it may have a serious underlying cause, such as infection, circulation problems, head trauma, autoimmune disease, or Meniere’s disease. 


Tinnitus or ringing in the ears is often among the first signs of hearing loss in the elderly. Sounds like buzzing, roaring, clicking, or hissing can be loud or soft and present in one or both ears. Tinnitus may be a sign of other health issues, such as high blood pressure and allergies, or occur as a side effect of certain medications.


Presbycusis is the gradual loss of hearing in older adults. The loss usually occurs in both ears at the same time. 

Causes of Hearing Loss

Age-related hearing loss usually results from changes in the inner and middle year or impairment in the nerves responsible for hearing, all of which are due to the natural aging process. Other causes include: 

  • Cumulative effects of long-term noise exposure
  • Changes in blood flow to the ear
  • Changes in the way that the brain processes speech and sound
  • Damaged inner ear hair cells that transmit sounds to the brain
  • Eardrum damage due to infection, pressure, or putting objects such as cotton-tipped swabs in the ear
  • Viral and bacterial infections
  • Head injury
  • Smoking
  • Health conditions such as:
  • Diabetes
  • High blood pressure
  • Atherosclerosis 
  • Kidney disease
  • Poor circulation
  • Heart conditions
  • Tumors 
  • Stroke
  • Ototoxic medications that are used to treat serious infections, cancer, and heart disease.

Coping with Hearing Loss

A gradual change in hearing affects the ability to understand speech and communicate and may impact seniors’ quality of life. It can cause depression, social isolation, and loss of self-esteem. Sometimes, the elderly may be mistakenly thought to be confused, unresponsive, or uncooperative because they can’t hear. 

Fortunately, there are steps your loved one can take to cope with hearing loss, for example:

  • Let others know they have a hearing problem    
  • Ask people to face them and to speak more slowly and clearly    
  • Pay attention to facial expressions or gestures
  • Ask the person to repeat if they don’t understand what he or she said
  • Look for a well-lit and quiet place to talk
  • Seek medical help to obtain a diagnosis
  • Learn lip reading
  • Join a support group. 

Keep on reading for some useful tips on how to communicate with older adults with hearing loss and make it easier for them to understand you.

How to Talk with Someone with Hearing Loss

  • Try to find a well-lit place without a lot of background noise 
  • In a group setting, make sure that only one person is speaking at once
  • Face the person, maintain eye contact, and speak clearly   
  • Don’t hide your mouth or eat while speaking
  • Speak at a natural, steady pace and just a little bit louder than you usually would, without shouting
  • Use facial expressions or gestures to provide clues as to what you’re saying    
  • Repeat what you said and use different words if necessary
  • Remain patient and positive.    

Devices to Help with Hearing Loss

If left untreated, hearing loss can have a significant impact on the senior’s quality of life. Treating hearing loss is important for many reasons, for example:  

  • People with untreated hearing loss are more likely to become socially isolated.
  • Cognitive abilities, such as memory and thinking,  are shown to decline faster in the elderly with hearing loss.
  • Unaddressed hearing loss can cause brain atrophy where unused parts of the brain start wasting away.
  • Hearing loss increases the risk of dementia.
  • Hearing plays an important role in balance and even a mild hearing loss may increase the risk of falls in the elderly.

Your loved one’s doctor may recommend one of the following devices to help with hearing loss:

  • Hearing aids
  • Cochlear implant
  • Assistive listening devices
  • Lessons in sign language or lip reading for severe hearing loss

Hearing aids

Hearing aids are amplifying devices that can help improve hearing, particularly in people with sensorineural hearing loss. Hearing aids can be adjusted to match individual hearing loss symptoms. They can, for example, allow you to hear high-frequency sounds without affecting other frequencies.

Although hearing aids can be very effective, they are not a suitable option for:

  • People with severe hearing loss
  • Older adults who are not able to manage changing batteries or making necessary adjustments
  • People with dementia whose auditory cortex may not adjust to hearing aids due to the dementia process affecting their brains.

Cochlear implants

A cochlear implant is a small electronic device that is surgically implanted in the ear. Cochlear implants can amplify sounds, but they don’t restore normal hearing. This option is only suitable for people with severe hearing loss who are not able to benefit from hearing aids. 

Assistive listening devices

Various amplification and communication devices can assist the elderly with hearing loss, such as:

  • Assistive devices for phones (alerting apps, video subtitling, speech-to-text translators, tools for learning sign language)
  • Assistive devices for TVs (wireless hearing aid accessories, loop systems, vocal clarity devices)
  • Pocketalkers, a simple hearing amplification device that can also be used by people who have dementia.

In the section below, we list different ways to prevent unnecessary hearing loss in the elderly.

Prevention of Hearing Loss

Although not all types of hearing loss can be prevented, there are steps your loved one can take to lower the risk of developing age-related hearing loss.

Avoid loud noises

One of the most important ways of preventing hearing loss is to stay away from loud and persistent noises that could damage the inner ear. Seniors should use earplugs to protect their hearing when exposed to noises of more than 85 decibels. In addition, when wearing headphones or earbuds, they should make sure to turn the volume down as low as possible.

Proper ear care

Poor hygiene habits often lead to earwax buildup, which could cause hearing loss. Instead of cotton swabs that may push the wax deeper into the ear, it is recommended to use at-home irrigation kits that soften the wax and make it easier to remove. 

Keep medical conditions under control

High blood pressure, heart disease, diabetes, and atherosclerosis that are not treated properly can lead to hearing loss, so keeping these medical conditions under control is essential. You should also keep in mind that some medications, such as diuretics and large doses of aspirin, can affect hearing. 

Visit a doctor regularly

One of the best ways to prevent hearing loss is by scheduling regular hearing exams. This way, if an issue is detected, the doctor can suggest treatment options to preserve your loved one’s hearing and stop it from deteriorating even further. It is also important to see a doctor as soon as possible if the senior experiences symptoms such as ear pain, fullness, or ringing, sudden change in hearing, or if there’s a family history of hearing loss.