Hearing Loss

National Institute on Aging

About one-third of Americans between the ages of 65 and 74 have hearing problems. About half the people who are 85 and older have hearing loss. Whether a hearing loss is small (missing certain sounds) or large (being profoundly deaf), it is a serious concern. If left untreated, problems can get worse.

Hearing loss can affect your life in many ways. You may miss out on talks with friends and family. On the telephone, you may find it hard to hear what the caller is saying. At the doctor's office, you may not catch the doctor's words.

Sometimes hearing problems can make you feel embarrassed, upset, and lonely. It's easy to withdraw when you can't follow a conversation at the dinner table or in a restaurant. It's also easy for friends and family to think you are confused, uncaring, or difficult, when the problem may be that you just can't hear well.

If you have trouble hearing, there is help. Start by seeing your doctor. Depending on the type and extent of your hearing loss, there are many treatment choices that may help. Hearing loss does not have to get in the way of your ability to enjoy life.

How Do I Know if I Have a Hearing Loss?

See your doctor if you:

Have trouble hearing over the telephone,
Find it hard to follow conversations when two or more people are talking,
Need to turn up the TV volume so loud that others complain,
Have a problem hearing because of background noise,
Sense that others seem to mumble, or
Can't understand when women and children speak to you.

What Should I Do?

If you have trouble hearing, see your doctor. Sometimes the diagnosis and treatment can take place in the doctor's office. Or your doctor may refer you to an otolaryngologist (oh-toh-layr-ehn-GOL-luh-jist), a doctor who specializes in the ear, nose, and throat. The otolaryngologist will take a medical history, ask if other family members have hearing problems, do a thorough exam, and suggest any needed tests. You may be referred to an audiologist (aw-dee-AH-luh-jist). Audiologists are health care professionals trained to measure hearing. The audiologist will use an audiometer to test your ability to hear sounds of different pitch and loudness. These tests are painless. Audiologists can help if you need a hearing aid. They can help select the best hearing aid for you and help you learn to get the most from it.

What Causes Hearing Loss?

Hearing loss can have many different causes, including the aging process, ear wax buildup, exposure to very loud noises over a long period of time, viral or bacterial infections, heart conditions or stroke, head injuries, tumors, certain medicines, and heredity.

What Different Types of Hearing Loss Are There?

Presbycusis (prez-bee-KYOO-sis) is age-related hearing loss. It becomes more common in people as they get older. People with this kind of hearing loss may have a hard time hearing what others are saying or may be unable to stand loud sounds. The decline is slow. Just as hair turns gray at different rates, presbycusis can develop at different rates. It can be caused by sensorineural (sen-soh-ree-NOO-ruhl) hearing loss. This type of hearing loss results from damage to parts of the inner ear, the auditory nerve, or hearing pathways in the brain. Presbycusis may be caused by aging, loud noise, heredity, head injury, infection, illness, certain prescription drugs, and circulation problems such as high blood pressure. The degree of hearing loss varies from person to person. Also, a person can have a different amount of hearing loss in each ear.

Tinnitus (tih-NIE-tuhs) accompanies many forms of hearing loss, including those that sometimes come with aging. People with tinnitus may hear a ringing, roaring, or some other noise inside their ears. Tinnitus may be caused by loud noise, hearing loss, certain medicines, and other health problems, such as allergies and problems in the heart and blood vessels. Often it is unclear why the ringing happens. Tinnitus can come and go, it can stop completely, or it can stay. Some medicines may help ease the problem. Wearing a hearing aid makes it easier for some people to hear the sounds they need to hear by making them louder. Maskers, small devices that use sound to make tinnitus less noticeable, help other people. Music also can be soothing and can sometimes mask the sounds caused by the condition. It also helps to avoid things that might make tinnitus worse, like smoking, alcohol, and loud noises.

Conductive hearing loss happens when something blocks the sounds that are carried from the eardrum (tympanic membrane) to the inner ear. Ear wax buildup, fluid in the middle ear, abnormal bone growth, a punctured eardrum, or a middle ear infection can cause this type of hearing loss. If ear wax blockage is a problem for you, the American Academy of Otolaryngology-Head and Neck Surgery suggests using mild treatments, such as mineral oil, baby oil, glycerin, or commercial ear drops to soften ear wax. If you think you may have a hole in your eardrum, however, you should see your doctor.

How Can I Help a Person with Hearing Loss?

Here are some tips you can use when talking with someone who has a hearing problem:

Face the person and talk clearly.
Speak at a reasonable speed; do not hide your mouth, eat, or chew gum.
Stand in good lighting and reduce background noises.
Use facial expressions or gestures to give useful clues.
Repeat yourself if necessary, using different words.
Include the hearing-impaired person when talking. Talk with the person, not about the person, when you are with others. This helps keep the hearing-impaired person from feeling alone and excluded.
Be patient; stay positive and relaxed.
Ask how you can help.

What Can I Do if I Have Trouble Hearing?

Let people know that you have trouble hearing.
Ask people to face you, and to speak more slowly and clearly; also ask them to speak without shouting.
Pay attention to what is being said and to facial expressions or gestures.
Let the person talking know if you do not understand.
Ask people to reword a sentence and try again.

What Devices or Treatments Can Help?

What will help you depends on your hearing problem. Some common solutions include:

Hearing aids. These are small devices you wear in or behind your ear. Hearing aids can help some kinds of hearing loss by making sounds louder. However, they sometimes pick up background noises - for example, traffic noise in the street or people talking at other tables in a crowded restaurant. This can affect how well you hear in certain situations. Before buying a hearing aid, check to find out if your insurance will cover the cost.

There are many kinds of hearing aids. An audiologist can help fit you with the hearing aid that will work best for you. You can ask the audiologist about having a trial period to try out a few different aids.

Remember, when you buy a hearing aid, you are buying a product and a service. Find a hearing aid dealer (called a dispenser) who has the patience and skill to help you during the month or so it takes to get used to the new hearing aid.

You may need to have several fittings of your hearing aid, and you will need to get directions on how to use it. Hearing aids use batteries, which you will need to change on a regular basis. They also may need repairs from time to time. Buy a hearing aid that has only the features you need.

Assistive/Adaptive Devices. There are many products that can help you live well with less-than-perfect hearing. The list below includes some examples of the many choices:

Telephone amplifying devices range from a special type of telephone receiver that makes sounds louder to special phones that work with hearing aids.
TV and radio listening systems can be used with or without hearing aids. You do not have to turn the volume up high.
Assistive listening devices are available in some public places such as auditoriums, movie theaters, churches, synagogues, and meeting places.
Alerts such as doorbells, smoke detectors, and alarm clocks can give you a signal that you can see or a vibration that you can feel. For example, a flashing light could let you know someone is at the door or that the phone is ringing.

Cochlear implants. If your deafness is severe, a doctor may suggest cochlear implants. In this surgery, the doctor puts a small electronic device under the skin behind the ear. The device sends the message past the non-working part of the inner ear and on to the brain. This process helps some people hear. These implants are not helpful for all types of deafness or hearing loss.

For More Information

Visit NIHSeniorHealth.gov (www.nihseniorhealth.gov), a senior-friendly website from the National Institute on Aging and the National Library of Medicine. The simple-to-use website features popular health topics for older adults. It has large type and a "talking" function that reads the text out loud.

National Institute on Aging U. S. Department of Health and Human Services National Institutes of Health September 2002 (Reprinted August 2005)

Web page last updated: December 20, 2005