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Age-Related Hearing Loss (Presbyacusis)

What is age related hearing loss?

The technical term is “presbyacusis”.

This is the gradual loss of hearing in both ears as we age. It is the most common communicative disorder in the elderly. Because the loss is gradual and slow, you may not have noticed that you are losing your hearing.

This type of hearing loss makes it particularly difficult to understand conversation in crowded places or in the presence of background noise.

Presbycusis is just one form of hearing loss that happens as you age. There are other conditions that affect hearing that also become more common with age. The most common of these is a condition called tinnitus, which causes you to hear ringing, buzzing, hissing, or roaring in one or both ears. Often presbycusis and tinnitus occur together.

Why do we lose our hearing as we grow older?

Many factors contribute to age-related hearing loss:

  1. Noise-long term exposure to sounds that are too loud for too long
  2. Cardiovascular risk factors-such as diabetes, heart disease and smoking
  3. Genetic-up to 50% of presbyacusis is genetically linked
  4. Ear diseases earlier in life
  5. Medications, taken in the past or present, that were harmful to the ears

Currently, it is not proven if you can prevent age-related hearing loss. However, the key to hearing health is to avoid factors that promote or accelerate its progression.

Protect yourself from noise-induced hearing loss, maintain a healthy lifestyle and if you have to be around loud noise (e.g at work or recreationally), then wear ear plugs to reduce the damage.

What other symptoms should I watch out for?

It is appropriate to visit the ENT doctor if any of the following occur:

  1. One sided sudden hearing loss
  2. Pain
  3. Dizziness
  4. Fluid coming from the ears
  5. Feeling of “fullness” in the ear
How can I tell if I have a hearing problem?

Ask yourself the following questions. If you answer “yes” to three or more of these questions, you could have a hearing problem and may need to have your hearing checked.

  1. Do you sometimes feel embarrassed when you meet new people because you struggle to hear?
  2. Do you feel frustrated when talking to members of your family because you have difficulty hearing them?
  3. Do you have difficulty hearing or understanding co-workers, clients, or customers?
  4. Do you feel restricted or limited by a hearing problem?
  5. Do you have difficulty hearing when visiting friends, relatives, or neighbors?
  6. Do you have trouble hearing in the movies or in the theater?
  7. Does a hearing problem cause you to argue with family members?
  8. Do you have trouble hearing the TV or radio at levels that are loud enough for others?
  9. Do you feel that any difficulty with your hearing limits your personal or social life?
  10. Do you have trouble hearing family or friends when you are together in a restaurant?

Adapted from: Newman, C.W., Weinstein, B.E., Jacobson, G.P., & Hug, G.A. (1990). The Hearing Handicap Inventory for Adults [HHIA]: Psychometric adequacy and audiometric correlates. Ear Hear, 11, 430-433.

What should I do if I have trouble hearing?

Hearing loss is a serious issue. There are two main health providers that you may visit; an ENT Surgeon or an Audiologist. Each has a different type of training and expertise. Each can be an important part of your hearing health care.

The doctor or audiologist will start by looking inside the ear with an otoscope. Based on your history, symptoms and other complaints, you may be sent for a formal hearing test called an audiogram.

What treatments or devices can help?

If you have presbycusis, you will probably br recommend hearing aids. But if you have other hearing problems, too, they might need different treatments. For instance, if you have too much wax in your ears, you will be taught how to get the wax out. And if you have ringing or buzzing in your ears because of tinnitus, you might need to learn special skills to manage that problem.

  • Hearing aids – You might not want to wear hearing aids because they make you feel embarrassed, or because you think they don’t work. If your doctor recommends them, try to keep an open mind, even if you have tried them in the past. Hearing aid technology has gotten a lot better. There are now lots of different types of hearing aids to try. It might take a few tries to find the right type of aid and the right settings, but hearing aids can really help. The key is to work with your ear doctor until you find the best option for you. Always tell him or her if you have problems with the way your hearing aids sound or fit.

The content on the Nairobi ENT website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions.


  1. Newman, Craig W., et al. “The Hearing Handicap Inventory for Adults: psychometric adequacy and audiometric correlates.” Ear and hearing6 (1990): 430-433.
  2. Sataloff’s comprehensive textbook of otolaryngology; head and neck surgery: Otology, Neurotology and Skull base surgery. 2016

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