What is age-related hearing loss?

Age-related hearing loss (also called presbycusis, 

pronounced prez-buh-KYOO-sis) is hearing loss that 

occurs gradually for many of us as we grow older. It is 

one of the most common conditions affecting adults 

as we age. Approximately 15% of American adults 

(37.5 million) ages 18 and over report some trouble 

hearing, and about one in three people in the U.S. 

between the ages of 65 and 74 has hearing loss. 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, respond to warnings, 

and hear phones, doorbells, and smoke alarms. 

Hearing loss can also make it hard to enjoy talking 

with family and friends, leading to feelings of isolation.

Hearing loss typically occurs in both ears as we age. 

Because the loss is gradual, you may not realize 

that you’ve lost some of your ability to hear.

Why do we lose our hearing as we 

get older?

Many things affect our hearing as we age. For 

example, changes in the inner ear that can affect 

hearing are common. Age-related changes in the 

middle ear and complex changes along the nerve 

pathways from the ear to the brain can also affect 

hearing. Long-term exposure to noise (https://www.

nidcd.nih.gov/health/noise-induced-hearing-loss) 

and some medical conditions can also play a role. 

In addition, new research suggests that certain 

genes make some people more susceptible to 

hearing loss as they age. 

Conditions that are more common in older people, 

such as high blood pressure and diabetes, are 

associated with hearing loss. In addition, medications 

that are toxic to the sensory cells in your ears (some 

chemotherapy drugs, for example) can cause hearing 

loss. Less commonly, abnormalities of the middle 

ear, such as otosclerosis (https://www.nidcd.nih.gov/

health/otosclerosis), can worsen hearing with age. 

Can I prevent age-related hearing loss?

Scientists don’t yet know how to prevent age-related 

hearing loss, but you can protect yourself from noiseinduced hearing loss. Potential sources of damaging 

noises (see https://www.nidcd.nih.gov/health/listeninfographic) include loud music, headphones/earbuds 

used at high volume, construction equipment, 

fireworks, guns, lawn mowers, leaf blowers, and 

motorcycles. To help safeguard your hearing as you 

age, avoid loud noises, reduce the amount of time 

you’re exposed to loud sounds, and protect your 

NIDCD Fact Sheet | Hearing and Balance

Age-Related Hearing 

Loss (Presbycusis)

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

NIDCD...Advancing the science of communication to improve lives
ears with earplugs or protective earmuffs (https://

www.nidcd.nih.gov/health/hearing-protectors). 

How can I tell if I have a hearing 

problem?

Ask yourself the following questions. If you answer 

“yes” to two or more of these questions, or 

“sometimes” to three or more of these questions, 

you could have hearing loss and should consider 

having your hearing checked.

1. Does a hearing problem cause you difficulty

when listening to TV or radio?

2. Does a hearing problem cause you difficulty

when attending a party?

3. Does a hearing problem cause you to feel

frustrated when talking to members of

your family?

4. Does a hearing problem cause you to feel left

out when you are with a group of people?

5. Does a hearing problem cause you difficulty

when visiting friends, relatives, or neighbors?

6. Do you feel challenged by a hearing problem?

7. Do you feel that any difficulty with your hearing

limits or hampers your personal or social life?

8. Does a hearing problem cause you to feel

uncomfortable when talking to friends?

9. Does a hearing problem cause you to avoid

groups of people?

10. Does a hearing problem cause you to visit

friends, relatives, or neighbors less often than

you would like?

Adapted from: Cassarly C, Matthews LJ, Simpson AN, Dubno JR. 

The Revised Hearing Handicap Inventory and Screening Tool Based 

on Psychometric Reevaluation of the Hearing Handicap Inventories 

for the Elderly and Adults. Ear Hear. 2020 Jan/Feb;41(1):95-105. 

doi: 10.1097/AUD.0000000000000746. PMID: 31124792; PMCID: 

PMC6864238.

What should I do if I have trouble 

hearing?

If you are concerned about your hearing, you have 

options for your next steps. Start by learning more 

about hearing loss. Depending on your symptoms, 

you might consider over-the-counter hearing aids

(https://www.nidcd.nih.gov/health/over-counterhearing-aids). If your symptoms are complex, or if 

you have questions about next steps, consider 

seeking advice from a hearing health care provider. 

Primary care physicians, otolaryngologists, and 

audiologists can be important parts of your hearing 

health care. Each has a different type of training 

and expertise:

} A primary care physician is a doctor who practices

general medicine and is often our first stop for

medical care. This health care provider can refer

you to a specialist, if needed, and can also help to

determine whether you have other medical

conditions that can contribute to hearing loss.

} An otolaryngologist (pronounced oh-toe-lair-inGAH-luh-jist) is a doctor who specializes in

diagnosing and treating diseases of the ear, nose,

throat, and neck. An otolaryngologist, often

called an ENT, will try to find out why you’re

having trouble hearing and offer treatment

options. Otolaryngologists often work closely

with and may refer you to an audiologist.

} An audiologist (pronounced aw-dee-AH-luh-jist)

has specialized training in identifying and measuring

hearing loss, determining where along the auditory

pathway there may be a problem with hearing,

and recommending and providing certain hearing

loss interventions, such as hearing aids.

2
What treatments and devices can help?

Treatment will depend on the severity of your 

hearing loss, so some treatments or devices will 

work better for you than others. A number of 

devices and aids can help when you have hearing 

loss. Here are the most common ones:

} Hearing aids (https://www.nidcd.nih.gov/health/

hearing-aids) are electronic instruments you wear

in or behind your ear. They make sounds louder.

For mild to moderate hearing loss, a new category

of hearing aids for adults was established in

2022 by the U.S. Food and Drug Administration.

These devices may be purchased over the counter

(OTC) from retail or online outlets without seeing

a health care professional or getting a hearing

test. If you have tried an OTC hearing aid without

success or have trouble hearing loud sounds,

consult a hearing health professional, because

your hearing loss may be more severe.

} Cochlear implants. Cochlear (pronounced COKElee-ur) implants (https://www.nidcd.nih.gov/health/

cochlear-implants) are small electronic devices

that are surgically implanted in the inner ear and

help provide a sense of sound to people who are

profoundly deaf or have severe hearing loss.

} Assistive listening devices (https://www.nidcd.nih.

gov/health/assistive-devices-people-hearing-voicespeech-or-language-disorders) include telephone

and cellphone amplifying devices, apps for use

with a smartphone or tablet, and closed-circuit

systems (hearing loop systems) in some theaters,

auditoriums, and places of worship.

How can my friends and family help me?

You and your family can work together to make 

living with hearing loss easier. Here are some things 

you can do:

} Tell your friends and family about your hearing loss.

Explain which listening situations are hard for you.

} Ask your friends and family to face you when they

talk so that you can see their expressions and lip

movements. This may help you to understand

what they’re saying.

} Ask people to speak louder, but not shout. You

may need to ask them to slow down when they

speak, or to speak more clearly.

} Turn off or turn down the volume of background

noise, such as the TV, when you’re trying to have

a conversation.

} Be aware of noise around you that can make hearing

more difficult. When you go to a restaurant, for

example, don’t sit near the kitchen or near a band

playing music. Ask for seating in a quiet area.

Sitting in a booth can help soften or block noise.

What research does NIDCD support on 

age-related hearing loss?

NIDCD supports research on the causes of agerelated hearing loss, including genes that may make 

this type of hearing loss more likely. NIDCD-funded 

scientists are working to understand what happens 

as we age that interferes with our ability to hear 

speech in a noisy environment. NIDCD also funds 

research that explores changes in how the brain 

processes sound when we lose our hearing. The 

research to date supports the use of hearing aids to 

maintain the brain’s sound-processing capabilities.

NIDCD-supported research provided critical data 

that contributed to the FDA’s decision (https://

www.nidcd.nih.gov/about/nidcd-director-message/

fdas-new-category-hearing-aids-advances-hearinghealth-care) to make hearing aids available over the 

counter, without a prescription or health care 

examination, for adults who believe they have mild 

to moderate hearing loss. NIDCD continues to 

support research on ways to make adult hearing 

health care more accessible and affordable (https://

www.nidcd.nih.gov/research/improve-hearinghealth-care). 

3
Age-Related Hearing Loss 

(Presbycusis)

NIH Pub. No. 23-DC-4235 

February 2023

For more information, contact us at:

NIDCD Information Clearinghouse

1 Communication Avenue 

Bethesda, MD 20892-3456

Toll-free voice: (800) 241-1044 

Toll-free TTY: (800) 241-1055

Email: nidcdinfo@nidcd.nih.gov

https://www.nidcd.nih.gov

 Follow the NIDCD on Twitter at @NIDCD

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.

Where can I find more information 

about age-related hearing loss?

NIDCD maintains a directory of organizations 

providing information on the normal and 

disordered processes of hearing, balance, taste, 

smell, voice, speech, and language. Visit the NIDCD 

website at https://www.nidcd.nih.gov/directory to 

see the directory.

To read more about hearing loss, visit:

} How Do We Hear?

} Do You Need a Hearing Test?

} Over-the-Counter Hearing Aids

} Hearing Aids

} Hearing Aids (FDA)

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

to read, print, or download fact sheets. 

NIH...Turning Discovery Into Health®