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Approximately one in three people in the United States between the ages of 65 and 74 have hearing loss, and nearly half of those older than 75 have difficulty hearing. Untreated hearing loss can make it hard to understand and follow a doctor’s advice, respond to warnings, 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.

Age-related hearing loss most often occurs in both ears, affecting them equally. Since the loss is gradual, you may not realize that you’ve lost some of your ability to hear.

There are many causes of age-related hearing loss. Most commonly, it arises from changes in the inner ear as we age, but it can also result from changes in the middle ear. Aging impacts the nerve pathways from the ear to the brain as well. Our auditory system becomes “less flexible” with age, which can contribute to hearing but not understanding clearly along with having difficulty hearing in noise. Certain medical conditions and medications may also play a role.

Why do we lose our hearing as we get older?

Many factors can contribute to hearing loss as you get older. It can be difficult to distinguish age-related hearing loss from hearing loss that can occur for other reasons, such as long-term exposure to noise.

Noise-induced hearing loss is caused by long-term exposure to sounds that are either too loud or last too long. This kind of noise exposure can damage the sensory hair cells in your ear that allow you to hear. Once these hair cells are damaged, they do not grow back, and your ability to hear is diminished.

Conditions that are more commonly found in older adults, such as high blood pressure or diabetes, can contribute to hearing loss as well. Medications that are toxic to the sensory cells in your ears (for example, some chemotherapy drugs) can also cause hearing loss.

Rarely, age-related hearing loss can is caused by abnormalities of the outer ear or middle ear. Such abnormalities may include reduced function of the tympanic membrane (the eardrum) or reduced function of the three tiny bones in the middle ear that carry sound waves from the tympanic membrane to the inner ear.

Most older people who experience hearing loss have a combination of both age-related hearing loss, noise-induced hearing loss, and changes to the nerve pathways from the ears to the brain.

Can age-related hearing loss be prevented?

At this time, scientists don’t know how to prevent age-related hearing loss; however there are some things to consider that may help. Protect yourself from noise-induced hearing loss by protecting your ears from sounds that are too loud and last too long. It’s important to be aware of potential sources of damaging noises, such as loud music, firearms, snowmobiles, lawn mowers, and leaf blowers. Avoiding loud sounds, reducing the amount of time you’re exposed to loud noise, and protecting your ears with ear plugs or ear muffs are easy things you can do to protect your hearing and limit the amount of hearing you might lose as you get older.

A healthy lifestyle (e.g., healthy diet and exercise, no smoking) is important to reduce the risk of age-related hearing loss as these reduce conditions that can contribute to hearing loss.

Finally, keep your hearing brain active. We hear with our brain and not our ears. Stay active and socially engaged. Research shows that playing a musical instrument or learning a second language are effective ways to stave off auditory nerve changes that happen with normal aging.

What to do in case you have trouble hearing?

Hearing problems can be serious, and treating early typically yields better outcomes. The most important thing you can do if you think you have a hearing problem is to seek advice from an audiologist, don’t just go “shopping” for hearing aids. Audiologists provide patient-centered care in the prevention, identification, diagnosis, and evidence-based intervention and treatment of hearing, balance, and other related disorders.

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