Definition - What is age-related hearing loss?

Age-related hearing loss is a naturally declining hearing in old age. It begins with a barely noticeable hearing loss around the fiftieth year of life and worsens gradually over time.

Those affected notice this at the beginning, especially in an increasing inability to perceive high pitches clearly and that background noises can not be filtered out so well from a conversation. As a rule, both ears are equally hard hit by the change.


The most important cause of senile hearing loss is already in their name. It is the advancing age that leads to decreased hearing.

The hair cells in the inner ear, which are responsible for the perception of sounds and noises, naturally exploit themselves. With every audible tone, they are deflected differently in one direction, depending on the volume and pitch. Over time, their flexibility and strength decreases just as it does with other body parts. Similar to age-related hearing loss, age-related skeletal changes are similar to arthritis. In the case of hair cells, especially very high tones in the high-frequency range require a strong deflection of the hair cells. Therefore, it is logical that this sound area is affected first.

In addition to the hair cells, however, age-related changes in the brain also influence the age-related hearing loss. The flexibility in thinking processes and the processing of new stimuli decreases with decreasing brain matter in old age. That does not mean that older people become stupider. Rather, it means that they can not adjust so well to current stimuli. Sounds and sounds are acoustic stimuli and are thus affected by the altered processing.

Environmental factors such as increased noise throughout life may lead to earlier onset of senile hearing loss. On the other hand, noise deafness can not be equated with age-related hearing loss. Medications such as specific antibiotics or infections are rarely the reason for a significant hearing loss in old age. Although they can damage the hair cells, they usually do not trigger a typical age-related hearing loss.


The diagnosis of an age hearing loss is made by an ENT specialist. This can perform various tests for it. The choice of hearing test depends on the cooperation and the abilities of the patient.

As a rule, an audiometry is performed, which represents the hearing range of the person concerned in a diagram compared to normal healthy. To perform the test, the sufferer must wear a pair of headphones and press a button when hearing a tone in an ear. A significant deviation in the high-frequency range speaks for an age hearing loss.

Audi grams

An audiogram is a graphical representation of subjective hearing. The horizontal axis represents the frequency range in Hertz and the vertical axis represents the sound pressure level in decibels. The entered data is obtained from the previously performed hearing test with the test person and results in the so-called "hearing curve". An audiogram of a normal healthy equals a horizontal line around zero decibels.

With an age-related hearing loss, the curve drops significantly from about one thousand hertz to about forty decibels until it reaches a plateau again in the frequency range around four thousand to eight thousand hertz.

Accompanying symptoms

Accompanying symptoms of senile hearing loss can be multifaceted. An indication may be an incipient inability to separate separate sources of noise and concentrate on the desired noise.

In technical terms, this is described as a cocktail party effect. He also describes a concrete situation in which this phenomenon can be observed. If a victim is at a cocktail party, there are usually many people in a room and the atmosphere is very noisy. In such a background, a normal hearing person can concentrate well on his conversation with the other person and can virtually "suppress" the background noise. Someone with an age-related hearing loss can not do this and feels the background noises as loud as the conversation with their counterpart. If affected by this phenomenon, a hearing test can provide certainty.

In addition to this altered perception of hearing, it is most likely still a diminishing cognitive performance that can be observed. But it does not necessarily have to go hand in hand with a decline in hearing. It is rather to be considered that an incipient aging process does not just concretely start with a body part or organ. Rather, it affects the whole body. Not infrequently, in addition to an incipient senile hearing loss, for example, a diminishing sight or skeletal changes are also observed.

Which frequencies are affected?

Above all, frequencies in the ascending range from one thousand hertz are affected. Experts speak here of the high-frequency range. However, it must be taken into account here that the perception of hearing is not only dependent on the frequency, but also on the sound pressure level. The perception of hearing in the interplay of decibel and hertz must therefore always be considered in relation to one another.

What treatment options are there?

An adult hearing loss need only be treated if it affects the person affected and he wishes to receive therapy. The simplest treatment option is the use of hearing aids. These can be selected from a hearing care professional of choice. It is important to find an individually fitting model that offers a very high wearing comfort. Only in this way is it possible to wear it regularly. Depending on your preference, the hearing aid can be worn either behind the ear or in the ear. A detailed testing and education on the handling of the devices will convey the expert.

Although an operation is conceivable to improve an inner ear hearing loss such as the hearing loss, but in the specific case of senile hearing loss, the surgical intervention is not recommended. It is a progressive process of degeneration affecting not only the inner ear, but in many cases also the auditory nerve. However, to be successful with the surgery, the auditory nerve must be intact. If this is impaired in its function, an inserted implant in the inner ear (a so-called cochlear implant) can not cause any improvement.

Therefore, a significant increase in the quality of life in the form of undisturbed communication can only be achieved with hearing aids. They are also much less risky in their application than surgery and can be removed, reused or adjusted at will.

When do I need a hearing aid?

It depends entirely on the subjective well-being, from when the use of a hearing aid makes sense. If conversations can only be made more difficult or if everyday life is strongly influenced by the declining hearing, it is recommended to use a hearing aid at least on a trial basis. During this trial period, the person concerned can then decide for themselves whether the hearing aids will improve or not.

Those affected will usually find the right time later than the environment. Often it is family members or related persons who perceive the hearing loss as disturbing in the communication. So if people in their environment address this problem, sufferers should not react with false pride or be offended. Rather, they should accept it as good advice. Because the sooner you use a hearing aid, the easier it is to handle the new equipment, and the more easy it is to stop hearing. Anyone who is unsure whether their hearing is declining, can also make a non-binding hearing test at the ENT specialist or in a specialist hearing aid business. The test result is only a recommendation for further action and is not an obligation.


The use of homeopathic remedies can neither cure nor significantly prevent the onset of old age hearing loss. However, since the balance of the electrolytes in the inner ear plays a major role, the targeted intake of potassium chloratum globules may possibly bring an improvement. They also add minerals in the form of potassium chloride to the body, which can have a positive effect on the hair cells. Scientifically, this has not been proven.


The course of an age-related hearing loss can be individually different. In the majority of cases, however, a typical course of the disease can be detected. The onset is usually around the age of fifty and shows in a declining ability to perceive high frequencies. Affected people notice this in a declining perception for high notes. Women's and children's voices can often be understood worse and worse. Over time, the perception of hearing deteriorates further. This is a slow process and often goes unnoticed.

Compared to normal healthy, there is an increase in the discomfort threshold compared to noise. A practical example would be television. Concerned people have a significantly higher volume at which they can track a program well, but the normal healthy as annoying or painfully loud.

It can not be said exactly how far the hearing loss will progress. This depends on individual factors such as other diseases. Deafness is not expected. Especially in the advanced stage of senile deafness, dark tones such as a deep voice can often be well understood. In addition, the timely use of hearing aids promises a significant improvement he complaints.

What degree of disability is there for a hearing loss?

The degree of disability (GdB) depends on hearing loss in percent to normal healthy. The percentage hearing loss can be determined from a created audiogram of the person concerned by means of a 4-frequency table. Starting with a 20-40% hearing loss, a GdB of 10-20 will be awarded. A 40-60% hearing loss gives a GdB of 30 and a 60-80% hearing loss a GdB of 50.

For the recognition of a GdB it requires an expert opinion. In addition, factors such as age in the development of deafness as well as concomitant speech disorders and other disabilities play a role in the calculation of the degree. In general, it is difficult to recognize an age-related hearing loss as a degree of disability, as it does not affect all frequencies. In severe cases, however, it can be counted towards further physical disabilities, to get compensation for disadvantages.

Is there a correlation between presbycusis and dementia?

In general, it has to be made clear that age-related hearing loss and dementia are two separate clinical pictures. They can therefore be independent of the other clinical picture. Both diseases, however, occur more often in older age, so that they are often present in those affected side by side. However, dementia does not cause any hearing impairment or promotes their onset. It's the same with age-related hearing loss.

Is senile deafness inheritable?

It has not been proven that age-related hearing loss is inheritable. Genetic factors are more likely to affect hearing loss, which occurs at a young age. The predisposition to age-related hearing loss contributes to everyone. This circumstance is comparable with all age-related degradation processes. For example, all joints of older people look different in age compared to young people. Almost nothing can be done against this aging process. When and how strongly the aging process begins, however, can be influenced by lifestyle and genetic factors.

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