Hearing Loss as You Age: What to Know

Hearing loss can sneak up on us — so gradually that many of us don’t notice the change. You might think: Wow, was that restaurant noisy? I couldn’t hear a thing. My TV must be breaking down. I keep having to turn up the volume.

But it might not be the TV or the restaurant; it might be you.

One classic symptom, said Jennifer Gonzalez, an audiologist at the Mayo Clinic in Phoenix, is a feeling that everyone around you has suddenly decided to mumble. When older patients are brought in to see her — usually by an exasperated relative who is tired of repeating themselves — “They’ll say, ‘Oh, no, I hear just fine. Everybody else just needs to speak more clearly,’” Dr. Gonzalez explained.

Age-related hearing loss, or presbycusis, is incredibly common, affecting about 13 percent of adults in their 50s and over half of Americans over 70. While you can’t prevent it, there are ways to protect your hearing right now.

Research shows people wait an average of 10 years before getting help with hearing loss. But the quality of our hearing affects our overall health as we age, said Frank Lin, director of the Cochlear Center for Hearing and Public Health at Johns Hopkins University. Hearing loss has been linked with conditions such as dementia, depression and falls. So it’s important to know the signs.

Some early signals include having trouble hearing conversations when two or more people are talking, or struggling to comprehend if there is background noise, like in a crowd, Dr. Lin said. You might also have more difficulty hearing higher-pitched sounds (like children’s voices), because we lose the ability to hear higher frequencies first, he explained.

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Kelly Dwyer, chief of audiology for Emory Healthcare in Atlanta, says that most of the time, somebody else notices it first. “The majority of patients that see me will say, ‘My wife thinks I can’t hear,’” she said.

Another warning sign, Dr. Dwyer added, is if “you’re starting to get nervous about situations in which it may be harder to hear,” she said. “Patients will say, ‘I don’t go to church anymore,’ or ‘My grandkids don’t even try and talk to me because I can’t hear them.’”

The National Institutes of Health has a list of questions to ask yourself if you think you might be losing your hearing.

Dr. Gonzalez said she asks patients in their 60s when they last had their hearing checked, “and they’ll say, ‘Oh, I haven’t had my hearing tested since I was in school.’”

If you have symptoms, make an appointment to see an audiologist, said Dr. Gonzalez. The Centers for Disease Control and Prevention also recommends that you ask for a hearing test during your annual checkup with your doctor.

If you’d rather test yourself at home, the Cochlear Center for Hearing and Public Health directs you to a free hearing number test that assesses your hearing. (It’s only available for iPhones, Dr. Lin said, but the Center is developing a similar app for both Android and iOS that will be available this fall.)

You can also use your computer to take the National Hearing Test, developed by the N.I.H., for an $8 fee. (It’s free for AARP members.)

Your ability to hear can be worsened by routine noise exposure, Dr. Lin said. Prolonged noise above 70 decibels may start to damage your hearing, according to the C.D.C. (A whisper is 30 decibels, while a siren tops out at 120.)

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And, if you’re listening to music or watching videos on a smartphone, the C.D.C. warns that the maximum volume allowed on these devices, 105-110 decibels, can cause hearing damage in less than five minutes.

“The rule of thumb is that, if you’re listening through headphones, if anyone else can hear anything from it, it’s too loud,” Dr. Dwyer said.

You might even be able to set your smartphone and wearable devices to alert you when your music is too loud or set a limit on how loud they can go, Dr. Gonzalez said.

Whether you have hearing issues or not, don’t use lawn mowers, power tools or leaf-blowers without ear protection, said Dr. Lin, and keep protective gear handy. Playing music in your earbuds doesn’t count and can make things worse. “I have a pair of earmuffs in my garage near my lawn mower, so I just naturally put them on,” he said.

And carry earplugs in your bag for noisy atmospheres, Dr. Dwyer said. (“Just the little squishy earplugs from the drugstore,” she explained.)

Dr. Gonzalez, a music lover, uses what are called musician’s earplugs when she goes to concerts, which protects the ears of people who play music without disturbing their perception of pitch, she said. “If you’re at a wedding reception or a bar where you’re around a lot of loud sound, but you still need to communicate, that’s a great option.”

Hearing aids have improved significantly in the last decade, Dr. Dwyer said: “They have better technology. They don’t squeal. They’re not big and beige.” And some connect wirelessly to other compatible Bluetooth devices, she said, so you can answer your phone or stream a podcast directly to your hearing aid.

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They’re more accessible, too. In 2022, the Food and Drug Administration announced new regulations allowing the sale of over-the-counter hearing aids, which the American Academy of Audiology estimates will cost between $300-600, compared to an average of $5,000 for a prescription hearing aid.

If you’re still feeling a little reluctant to wear them, consider that hearing aids have been shown to slow cognitive decline, said Dr. Gonzalez, so they may be good for brain health too.


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