Presbycusis

Age related gradual hearing loss, very common in older adults

Overview

Presbycusis is the most common form of hearing loss and the gradual, usually symmetrical decline in hearing that accompanies ageing. It typically begins in the high frequencies and progresses slowly over decades, so consonants such as s, t, and f become hard to distinguish and speech can seem mumbled, especially in background noise. Contributing factors include cumulative loss of cochlear hair cells, degeneration of the stria vascularis that powers the cochlea, loss of auditory nerve fibres and synapses, reduced blood supply, lifetime noise exposure, and genetic predisposition. Changes in central auditory processing add to the difficulty of following speech. Hearing aids are the usual form of management, and cochlear implants are used when loss becomes severe. Untreated age related hearing loss has been associated in research with social isolation, depression, and cognitive decline, which has made it a focus of public health attention.