One of the main contributors to presbycusis is noise. We live in a very noisy world and it is clear that our hearing suffers as a result. Hearing protection devices and noise-reduction techniques prevent this from happening. Speech sounds cover a wide range of frequencies so that both the type and degree of hearing loss determine its impact. Sensory presbycusis begins in the highest frequencies, actually above the speech range at first.
Tinnitus annoys some people but most accept the ringing as a normal part of presbycusis.
Fortunately, the ringing comes and goes and is easily masked by background sounds. Background noise adds to the problem. With some forms of presbycusis, all frequencies are affected so that people complain of not being able to hear the speaker but are able to understand if the speech is made louder. The difficulties in speech understanding due to presbycusis may be compounded by aging in the brain, which is evident mainly from a slowing of speech processing. Seniors often note more difficulty in speech understanding than younger persons with the same degree of hearing loss.