Home > GOLDEN YEARS > Symptoms and People at Risk of Hearing Screening

Symptoms and People at Risk of Hearing Screening


Even though many elderly retain good hearing with age, age related hearing loss is common among elderly.  It is essential to screen for hearing loss in the elderly as increasing age is the most important risk factor for hearing loss.

Presbycusis is a term for age related hearing loss in the elderly. In people over the age of 55, it is the most common cause of hearing loss.

The hearing loss is a gradual process. It usually develops over several years. Usually, both ears are equally affected. The most affected sound range is usually the high-frequency (high pitch).


Loss of hearing often occurs slowly over time.

Symptoms include:

  • Gradual difficulty to hear the telephone ringing or birds singing

  • Difficulty hearing people nearby

  • Difficulty  in following a conversation in a group or noisy room

  • Difficulty in using the telephone

  • Comments from friends or family that the television is being loud

  • Family and friends have to repeat themselves more often to people with hearing loss

  • Frequently asking people to repeat themselves

  • Frustration at not being able to hear

  • Certain sounds seeming overly loud

  • Problems hearing in noisy areas

  • Problems telling apart certain sounds such as “s” or “th”

  • More difficulty understanding people with higher-pitched voices

  • Ringing in the ears

Among the elderly who are at risk for hearing loss?

There is no single identifiable cause to explain for age-related hearing loss. Frequently, it is due to the changes in the inner ear that happens as a person gets older.

 The following factors contribute risk for age-related hearing loss:

  • Family history  (age-related hearing loss tends to run in families)

  • Repeated exposure to loud noises (e.g. rock concerts or music headphones)

  • Smoking (smokers are more likely to have such hearing loss than non smokers)

  • Certain medical conditions such as diabetes, heart disease and high blood pressure. (These diseases causes arteriosclerosis which is hardening and narrowing of the blood vessels to the cochlea thus reducing blood supply to this vital part of hearing component in the inner ear)

  • Ototoxic drugs or chemicals e.g. gentamycin

  • Cerumen impaction

  • Recurrent and chronic infection of the inner ear

  • Overweight

  • Genetic factor- there may also be some hereditary reasons for presbyacusis


Hearing loss becomes noticeable when there are significant amount of damage to the sound receptors (nerve cells) of the inner ear. Many do not become completely deaf. The degree of the hearing loss differs from person to person of the similar age. It is helpful to identify the symptoms of hearing loss in the elderly and its associated risk factors so that hearing screening can be performed and hearing aids offered when definite hearing loss is confirmed.


  1. US Preventive Srvice  Task Force

  2. http://www.patient.co.uk/health/Presbyacusis-(Hearing-Loss-of-Older-People).htm

Last Review : 20 January 2014
Writer : Dr. Ruziatun binti Hasim