Hearing Loss Is Common Among Older Adults
Age-related hearing loss (presbycusis) is the loss of hearing that gradually occurs as a result of our body’s aging process. It is one of the most common conditions affecting older adults, according to the National Institute on Aging.
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A July 2023 JAMA Open Network study reports that more than 65 percent of people in a representative population survey ages 71 years or older had hearing loss, and by age 90 years, more than 96 percent had hearing loss.
However, fewer than one in three used hearing aids to treat their hearing loss. Untreated hearing loss is associated with other health risks including dementia and falls.
A December 2023 Lancet Healthy Longevity report says the regular use of hearing aids among adults with hearing loss is associated with a 24 percent cut in risk of early death.
Falls: Our ears play an important and large role in our balance. Frank Lin, M.D., Ph.D., and colleagues at Johns Hopkins found that even a mild hearing loss increases the risk of falls threefold, with the risk increasing as hearing loss worsens. According to the Centers for Disease Control and Prevention, falls among older adults can reduce the ability for older adults to remain independent.
Cognitive Function: Those with mild hearing impairment (unable to hear whispering) are twice as likely to develop dementia compared with those with typical hearing. The risk increases threefold for those with moderate hearing loss (unable to hear talking), and five-fold for those with severe impairment (unable to hear a doorbell). Researchers believe the connection may be due to those with hearing loss straining to decode sounds, increasing the brain’s cognitive load.
According to research by Frank Lin, M.D., Ph.D., at Johns Hopkins University: “Hearing loss can make the brain work harder, forcing it to strain to hear and fill in the gaps. That comes at the expense of other thinking and memory systems. Another possibility: Hearing loss causes the aging brain to shrink more quickly. A third possibility is that hearing loss leads people to be less socially engaged, which is hugely important to remaining intellectually stimulated. If you can't hear very well, you may not go out as much, so the brain is less engaged and active.”
A January 2024 Danish study in JAMA Otolaryngology–Head & Neck Surgery using data from over 573,000 people—the largest of its kind to date—found that untreated hearing loss is associated with a greater risk of dementia, but that hearing aid use appears to cut the risk.
See our Hearing Loss and Brain Health page for more information.
Heart Health: Six decades of research suggests a link between our cardiovascular and hearing health.
Raymond Hull, Ph.D., who analyzed 70 scientific studies, believes, “Our entire auditory system, especially the blood vessels of the inner ear, needs an oxygen-rich nutrient supply. If it doesn’t get it due to cardiovascular health problems, then hearing can be affected.” Cardiovascular disease appears to exaggerate the impact of those causes and intensify the degree of hearing decline. This compounded effect not only increases the difficulty a person experiences in perceiving what has been said, but also diminishes their ability to make sense of what they hear with speed and accuracy.
David R. Friedland, M.D., found that audiogram pattern correlates strongly with arterial disease, even acting as a heart-health test for those at risk. His study concluded that patients with low-frequency hearing loss may have a greater likelihood of cardiovascular events. Subsequent research has suggested that hearing loss may be an early sign of cardiovascular disease and that preventing atherosclerosis (hardening of the arteries) may help to prevent or delay the onset of hearing impairment.
Diabetes: The National Institutes of Health found that hearing loss is twice as common among people with diabetes compared with those who do not have the disease. Also, of the 79 million adults thought to have prediabetes, the rate of hearing loss is 30 percent higher than in those with normal blood sugar levels.
Research suggests that diabetes may lead to hearing loss by damaging the nerves and blood vessels of the inner ear, which has also been shown in autopsies of patients with diabetes.
Kidneys: A 2010 Australian study examined the medical records of 2,500 people ages 50 and older. One fifth had moderate chronic kidney disease, and more than half of all the patients with chronic kidney disease had some degree of hearing loss, compared with 28 percent of those who had no kidney problems. In addition, nearly a third of the chronic kidney disease patients had a severe hearing loss compared with just 10 percent among those patients without kidney issues.
According to the researchers, “The link can be explained by structural and functional similarities between tissues in the inner ear and in the kidney. Additionally, toxins that accumulate in kidney failure can damage nerves, including those in the inner ear.” Also, some drug treatments for kidney ailments are ototoxic, meaning they can harm hearing.
Regardless of age, type of hearing loss, or cause, hearing loss if left untreated or undetected can negatively affect overall health.
Besides treating hearing loss with hearing devices as needed, and using them regularly, the National Council on Aging has these tips for keeping the brain fit.
Causes of Age-Related Hearing Loss
There are many causes of age-related hearing loss, according to the NIDCD. Most commonly, it arises from changes in the inner ear as we age, but it can also result from changes in the middle ear, from complex changes along the nerve pathways from the ear to the brain, or from the cumulative effects of long-term noise exposure.
Hearing loss can also be caused by viral or bacterial infections, heart conditions or stroke, head injuries, tumors, and certain medicines, as well as continued and prolonged exposure to noise.
Age-related hearing loss most often occurs in both ears, affecting them equally. Because the loss is gradual, a person may not realize that the ability to hear has diminished. Often it is family or friends who notice first. Signs include needing the turn the TV volume up loudly, missing words in conversations, and having difficulty using the phone.
If you have experiencing difficulties with hearing or balance or bothersome tinnitus, schedule a visit with your healthcare provider, audiologist, and/or ENT.
The information provided here is for general purposes only. Please consult your healthcare provider for individual needs.
Updated January 2024.
When and why does age-related hearing loss relate to neuroimaging metrics of brain structure? Age-related hearing loss appears to occur with changes in brain structure across multiple research studies, but not in every study. This webinar presented by Mark Eckert, Ph.D., critically examines these correlational observations and address their functional significance. A 2009 Emerging Research Grants scientist, Eckert is a professor in the department of otolaryngology–head and neck surgery at the Medical University of South Carolina, where his research includes the study of communication problems using neuroimaging methods.
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