Is Hearing Loss an Inevitable Part of Aging? : The Hearing Journal – LWW Journals

Is Hearing Loss an Inevitable Part of Aging? : The Hearing Journal – LWW Journals

Physicians, the public, and perhaps even some audiologists think that hearing loss is part of normal aging, as shown by the use of the outmoded and inaccurate descriptors “presbycusis” and “age-related hearing loss.” Hearing loss is certainly common with age,1 but analysis of other conditions common in older people, forgotten studies of hearing in isolated populations not exposed to noise, and recent research support the conclusion that hearing loss with age largely represents noise-induced hearing loss. It’s time to retire the outdated terms and replace them with “sociocusis,”2 hearing loss from noise exposure in everyday life, or “noise-induced hearing loss in the elderly.” Hearing loss, hearing aids, presbycusis.

Why does this matter? Definitions convey meaning. If an unwanted condition that occurs with age is inevitable, there’s no use trying to prevent it. If, however, the condition is easily preventable, it’s probably worth trying. Unlike many conditions common with aging—muscle weakness, obesity, hypertension, Type II diabetes, heart disease among them—preventing noise-induced hearing loss is easy and inexpensive. Simply avoid loud noise exposure, leave noisy environments, and if one can’t do that, use hearing protection.

The goal of normal or healthy aging has been called “compression of morbidity”3 or “squaring the survival curve.”4 Although the biological bases of aging are still not precisely known, with theories based on genetic or biochemical changes in cells and subcellular structures over time,5 aging itself is readily apparent. Weight increases, hair thins and turns gray, skin wrinkles, hearing worsens, and eventually everyone dies. That disease, disability, and early death are not part of normal aging is shown by “Blue Zones,”6 where many live long and active lives into their 90s. Genetics plays a role, but diet, exercise, social relationships, and a little bit of alcohol appear to prolong healthy functional life. The question is: What is normal aging, and what is abnormal aging? Muscle weakness, obesity, hypertension, diabetes, and heart disease are not inevitable phenomena of normal physiological aging. Neither is hearing loss.


The impacts of hearing loss are underestimated because it is an invisible disability that usually becomes apparent late in life, when people with hearing loss are retired. There is little economic impact, especially because hearing health care and hearing aids have scant insurance coverage.7 Unlike the blind, the hard of hearing can compensate for their hearing loss and readily maintain their independence. Most people think hearing loss is benign.

Of course, that isn’t true. Hearing loss worsens social isolation and is strongly correlated with depression, dementia, falls and death.8 Amplification is the only treatment for hearing loss, but due to stigma9 and cost only a minority of those who need hearing aids have them.10 Hearing aids are imperfect and inconvenient substitutes for preserved hearing, so many who acquire them don’t wear them.11


Normal aging is most accurately described by physiological parameters. …….