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Presbycusis: Definition, Symptoms & Treatment

Instructor: Danielle Haak

Danielle has a PhD in Natural Resource Sciences and a MSc in Biological Sciences

Presbycusis is something many of us will eventually have to deal with - it is hearing loss that occurs with age. Read through this lesson to learn what causes it, what the symptoms are, and possible treatment options.

What Is Presbycusis?

I don't think I'm alone in lamenting about how many times my poor grandpa says 'what?' over the phone during a single conversation. But it turns out this is a really common problem! Presbycusis is a type of sensorineural hearing loss that commonly occurs with age. Sensorineural hearing loss occurs when there is damage to the inner ear. It is estimated that about one-third of people between the ages of 65 and 75 have some kind of hearing loss, and that number rises up to almost half of people over the age of 75 (meaning, it's okay grandpa, you're not alone!). Presbycusis is a gradual loss that slowly happens over time, often creeping up on people. It typically affects both ears equally.

How Hearing Works

Understanding the reasons behind presbycusis requires first understanding how we hear. First, sound waves enter the outer ear and travel through the ear canal to the eardrum. The eardrum vibrates and transmits these vibrations to the middle ear. Bones in the middle ear transmit these vibrations to fluid in the cochlea in the inner ear. The vibrations cause the fluid to ripple, affecting the hair cells (sensory cells) found there. As the hair cells move up and down, they bump into their neighboring structure, triggering the formation of electrical signals. The auditory nerve then sends these electrical signals to the brain where the sounds are identified and interpreted.

Presbycusis is usually caused by damage to the inner ear, shown here in purple.
diagram of ear

Causes of Presbycusis

The most common cause of presbycusis is a combination of age-related and noise-induced hearing loss. Over time, these hair cells (sensory cells) in the inner ear disappear, meaning less information can be transmitted (i.e., hearing loss occurs). This happens gradually over time, with age, or as the result of long-term exposure to loud noises that cause damage. In rare cases, the middle ear or nerve pathways may become damaged, causing hearing loss, or the auditory nerve may get damaged, disrupting the flow of signals to the brain. Finally, presbycusis can be caused by changes in the blood supply to the ear or as a side effect of certain medications.

Symptoms of Presbycusis

Obviously the primary symptom of presbycusis is hearing loss, but specifically how does this affect someone? Usually, high-pitched noises are the first to go. The person experiencing the hearing loss may not even realize it because the changes are so gradual over time, so he or she may start speaking louder than normal or have trouble differentiating sounds over background noise. Understanding speech becomes difficult and deeper pitches are easier to hear than higher ones. They may also experience the sensation of 'ringing' in the ears. Over time, this can affect someone's quality of life and lead them to feel isolated or depressed.

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