U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ∙ National Institutes of Health 

NIDCD Fact Sheet | Hearing and Balance 

Hearing Loss and Older Adults 

What is hearing loss? 

Hearing loss is a sudden or gradual decrease in how well 

you can hear. It is one of the most common conditions 

affecting older and elderly adults. Approximately one 

in three people between the ages of 65 and 74 has 

hearing loss, and nearly half of those older than 75 have 

difficulty hearing. Having trouble hearing can make 

it hard to understand and follow a doctor’s advice, to 

respond to warnings, and to hear doorbells and alarms. 

It can also make it hard to enjoy talking with friends and 

family. All of this can be frustrating, embarrassing, and 

even dangerous. 

Do I have a hearing problem? 

Ask yourself the following questions. If you answer “yes” 

to three or more of these questions, you could have a 

hearing problem and may need to have your hearing 

checked by a doctor. 

YES NO 

£ £ Do I have a problem hearing on the telephone or 

cell phone? 

£ £ Do I have trouble hearing when there is noise in 

the background? 

£ £ Is it hard for me to follow a conversation when two 

or more people talk at the same time? 

£ £ Do I have to strain to understand a conversation? 

£ £ Do many people I talk to seem to mumble (or not 

speak clearly)? 

YES NO 

£ £ Do I misunderstand what others are saying and 

respond inappropriately? 

£ £ Do I often ask people to repeat themselves? 

£ £ Do people complain that I turn the TV volume up 

too high? 

What should I do if I have 

trouble hearing? 

Hearing problems can be serious. The most important 

thing you can do if you think you have a hearing problem 

is to seek professional advice. There are several ways to 

do this. You can start with your primary care physician, 

an otolaryngologist, an audiologist, or a hearing aid 

specialist. Each has a different type of training and 

expertise. Each can be an important part of your hearing 

health care. 

An otolaryngologist (oh-toe-lair-in-GAH-luhjist) is a doctor 

who specializes in diagnosing and treating diseases 

of the ear, nose, and throat. An otolaryngologist will 

try to find out why you’re having trouble hearing and 

offer treatment options. He or she may also refer you to 

another hearing professional, an audiologist (aw-deeAH-luh-jist). An audiologist has specialized training in 

identifying and measuring the type and degree of hearing 

loss and recommending treatment options. Audiologists 

also may be licensed to fit hearing aids. Another source 

of hearing aids is a hearing aid specialist, who is licensed 

by a state to conduct and evaluate basic hearing tests, 

NIDCD...Improving the lives of people with communication disorders 
offer counseling, and fit and test hearing aids. You must 

be examined by a physician before you can be fitted for 

a hearing aid, although federal law allows you to sign a 

waiver if you do not wish to be examined before you 

purchase an aid. 

Why am I losing my hearing? 

Hearing loss happens for different reasons. Many people lose 

their hearing slowly as they age. This condition is known as 

presbycusis (prez-buh-KYOO-sis). Doctors do not know why 

presbycusis affects some people more than others, but it seems 

to run in families. Another reason for hearing loss with aging 

may be years of exposure to loud noise. This condition is known 

as noise-induced hearing loss. Many construction workers, 

farmers, musicians, airport workers, yard and tree care workers, 

and people in the armed forces have hearing problems even in 

their younger and middle years because of too much exposure to 

loud noise. (Read the NIDCD fact sheets titled “Presbycusis” at 

http://www.nidcd.nih.gov/health/hearing/Pages/presbycusis.aspx

and “Noise-Induced Hearing Loss” at http://www.nidcd.nih.gov/

health/hearing/pages/noise.aspx for more information.) 

Hearing loss can also be caused by viral or bacterial 

infections, heart conditions or stroke, head injuries, tumors, 

and certain medicines. 

What treatments and devices 

can help? 

Your treatment will depend on your hearing loss, so some 

treatments will work better for you than others. There are a 

number of devices and aids that can improve hearing loss. 

Here are the most common ones: 

} Hearing aids are electronic instruments you wear in or 

behind your ear. They make sounds louder. Things sound 

different when you wear a hearing aid, but an audiologist

or hearing aid specialist can help you get used to it. To find 

the hearing aid that works best for you, you may have to 

try more than one. Ask your audiologist or hearing 

specialist whether you can have a trial period with a few 

different hearing aids. Both of you can work together until 

you are comfortable. (Read the NIDCD fact sheet “Hearing 

Aids” at http://www.nidcd.nih.gov/health/hearing/pages/

hearingaid.aspx for more information.)

} Cochlear (COKE-lee-ur) implants are small electronic 

devices surgically implanted in the inner ear that help 

provide a sense of sound to people who are profoundly 

deaf or hard-of-hearing. If your hearing loss is severe, 

your doctor may recommend a cochlear implant in one 

ear or both. (Read the NIDCD fact sheet “Cochlear 

Implants” at http://www.nidcd.nih.gov/health/hearing/

pages/coch.aspx for more information.)

} Assistive listening devices include telephone and 

cell phone amplifying devices, smartphone or tablet 

“apps,” and closed circuit systems (induction coil loops) 

in places of worship, theaters, and auditoriums. (Read 

the NIDCD publication “Assistive Devices for People with 

Hearing, Voice, Speech, or Language Disorders” at 

http://www.nidcd.nih.gov/health/hearing/Pages/

Assistive-Devices.aspx for more information.) 

} Lip reading or speech reading is another option that 

helps people with hearing problems follow conversational 

speech. People who use this method pay close attention 

to others when they talk, by watching how the speaker’s 

mouth and body move. 

Can my friends and family help me? 

Yes. You and your family can work together to make hearing 

easier. Here are some things you can do: 

} Tell your friends and family about your hearing loss. They 

need to know that hearing is hard for you. The more you 

tell the people you spend time with, the more they can 

help you. 

} Ask your friends and family to face you when they talk so 

that you can see their faces. If you watch their faces move 

and see their expressions, it may help you to understand 

them better. 

} Ask people to speak louder, but not shout. Tell them they 

do not have to talk slowly, just more clearly. 

} Turn off the TV or the radio if you aren’t actively listening 

to it. 

} Be aware of noise around you that can make hearing more 

difficult. When you go to a restaurant, do not sit near the 

kitchen or near a band playing music. Background noise 

makes it hard to hear people talk. 

Working together to hear better may be tough on everyone 

for a while. It will take time for you to get 

used to watching people as they talk and for people to get 

used to speaking louder and more clearly. Be patient and 

continue to work together. Hearing better is worth the effort. 

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Styles of hearing aids 

Credit: NIH Medical Arts 

Behind-the-ear (BTE) “Mini” BTE 

Receiver in 

ear canal 

In-the-ear (ITE) In-the-canal (ITC) Completely-incanal (CIC) 

Are there different styles of 

hearing aids? 

There are three basic styles of hearing aids. The styles differ 

by size, their placement on or inside the ear, and the degree 

to which they amplify sound. 

} Behind-the-ear (BTE) hearing aids consist of a hard 

plastic case worn behind the ear and connected to 

a plastic earmold that fits inside the outer ear. The 

electronic parts are held in the case behind the ear. 

Sound travels from the hearing aid through the earmold 

and into the ear. BTE aids are used by people of all ages 

for mild to profound hearing loss. 

A new kind of BTE aid is an open-fit hearing aid. Small, 

open-fit aids fit behind the ear completely, with only a 

narrow tube inserted into the ear canal, enabling the 

canal to remain open. For this reason, open-fit hearing 

aids may be a good choice for people who experience 

a buildup of earwax, since this type of aid is less likely 

to be damaged by such substances. In addition, some 

people may prefer the open-fit hearing aid because their 

perception of their voice does not sound “plugged up.” 

} In-the-ear (ITE) hearing aids fit completely inside the 

outer ear and are used for mild to severe hearing loss. 

The case holding the electronic components is made 

of hard plastic. Some ITE aids may have certain added 

features installed, such as a telecoil. A telecoil is a 

small magnetic coil that allows users to receive sound 

through the circuitry of the hearing aid, rather than 

through its microphone. This makes it easier to hear 

conversations over the telephone. A telecoil also helps 

people hear in public facilities that have installed special 

sound systems, called induction loop systems. Induction 

loop systems can be found in many churches, schools, 

airports, and auditoriums. ITE aids usually are not worn 

by young children because the casings need to be 

replaced often as the ear grows. 

} Canal aids fit into the ear canal and are available in 

two styles. The in-the-canal (ITC) hearing aid is made 

to fit the size and shape of a person’s ear canal. A 

completely-in-canal (CIC) hearing aid is nearly hidden 

in the ear canal. Both types are used for mild to 

moderately severe hearing loss. 

Because they are small, canal aids may be difficult for a 

person to adjust and remove. In addition, canal aids have 

less space available for batteries and additional devices, 

such as a telecoil. They usually are not recommended for 

young children or for people with severe to profound 

hearing loss because their reduced size limits their power 

and volume. 

Are new types of aids available? 

Although they work differently than the hearing aids 

described above, implantable hearing aids are designed to 

help increase the transmission of sound vibrations entering 

the inner ear. A middle ear implant (MEI) is a small device 

attached to one of the bones of the middle ear. Rather 

than amplifying the sound traveling to the eardrum, an 

MEI moves these bones directly. Both techniques have the 

net result of strengthening sound vibrations entering the 

inner ear so that they can be detected by individuals with 

sensorineural hearing loss. 

A bone-anchored hearing aid (BAHA) is a small device that 

attaches to the bone behind the ear. The device transmits 

sound vibrations directly to the inner ear through the skull, 

bypassing the middle ear. BAHAs are generally used by 

individuals with middle ear problems or deafness in one 

ear. Because surgery is required to implant either of these 

devices, many hearing specialists feel that the benefits may 

not outweigh the risks. 

3 
Where can I find additional 

information about hearing loss 

and older adults? 

The NIDCD maintains a directory of organizations that 

provide information on the normal and disordered 

processes of hearing, balance, taste, smell, voice, 

speech, and language. Visit the NIDCD website at 

http://www.nidcd.nih.gov to search the directory. 

Use the following keywords to help you find 

organizations that can answer questions and provide 

printed or electronic information on hearing loss and 

older adults: 

} Late-deafened adults 

} Hearing aids 

} Presbycusis 

More NIDCD fact sheets on Hearing and Balance: 

} Assistive Devices for People with Hearing, Voice, 

Speech, or Language Disorders 

} Cochlear Implants 

} Hearing Aids 

} Noise-Induced Hearing Loss 

} Presbycusis 

Visit the NIDCD website at http://www.nidcd.nih.gov 

to read, print, or download fact sheets. 

For more information, additional addresses and phone 

numbers, or a printed list of organizations, contact us at: 

The NIDCD Information Clearinghouse 

1 Communication Avenue 

Bethesda, MD 20892-3456 

Toll-free Voice: (800) 241-1044 

Toll-free TTY: (800) 241-1055 

Fax: (301) 770-8977 

Email: nidcdinfo@nidcd.nih.gov 

http://www.nidcd.nih.gov

 Follow the NIDCD on Twitter at @NIDCD 

The NIDCD supports and conducts research and 

research training on the normal and disordered 

processes of hearing, balance, taste, smell, voice, 

speech, and language and provides health information, 

based upon scientific discovery, to the public. 

Hearing Loss and Older Adults 

NIH Publication No. 13-4913 

Updated November 2013 

NIH...Turning Discovery Into Health®