Presbycusis

• Presbycusis is described as age-related hearing loss
• Presbycusis


  A type of sensorineural hearing loss that occurs as people get older, affecting high-pitched sounds first and more notably than lower-pitched sounds, with gradual and symmetrical hearing loss
• Causes of reduced hearing in presbycusis

  • Loss of hair cells in the cochlea
  • Loss of neurones in the cochlea
  • Atrophy of the stria vascularis
  • Reduced endolymphatic potential
• Risk Factors for presbycusis

  • Age
  • Male gender
  • Family history
  • Loud noise exposure
  • Diabetes
  • Hypertension
  • Ototoxic medications
  • Smoking
• Exposure to loud noise over time

  Key risk factor for presbycusis that can be addressed to potentially prevent or reduce the extent of presbycusis
• Prevention of presbycusis

  Hearing protection should be worn in environments with exposure to loud noises for prolonged periods to reduce the risk of presbycusis
• Occupations at risk of presbycusis

  • Woodworking
  • Construction
• Hearing loss in presbycusis

  Gradual and insidious
• Hearing loss in presbycusis

  • The loss of high-pitched sounds can make speech difficult to hear and understand, particularly in loud environments
  • Male voices may be easier to hear than female voices
  • Patients may present after others have noticed they are not paying attention or missing details of conversations
  • Patients may present with concerns about dementia, when in fact, the issue is hearing loss
  • There may be associated tinnitus (ringing in the ears)
• Patients with hearing loss

  More likely to develop dementia
• Diagnosis of presbycusis

  1. Audiometry is the investigation of choice for establishing the diagnosis and extent of hearing loss

  2. Presbycusis will give a sensorineural hearing loss pattern, with normal or near-normal hearing at lower frequencies and worsening hearing loss at higher frequencies
• Management of presbycusis

  1. The effects of presbycusis cannot be reversed

  2. Supporting the person to maintain normal functioning

  3. Optimising the environment, for example, reducing the ambient noise during conversations

  4. Hearing aids

  5. Cochlear implants (in patients where hearing aids are not sufficient)
• Last updated

  July 2021