Why Your Hearing Gets Worse as You Age and What to Do About It

Do you find yourself straining to hear certain sounds, turning up the volume on the radio or missing out on snatches of conversation?

Age-related hearing loss — also known as presbycusis — happens to most of us as we get older. In fact, nearly a third of American adults between the ages of 65 and 74 experience hearing loss, and almost half of those above 75 have trouble hearing, according to the National Institute on Deafness and Other Communication Disorders (NIDCD).

But is this loss of listening ability inevitable?

Here, Maura Cosetti, MD, director of the Ear Institute at the New York Eye and Ear Infirmary of Mount Sinai, explains how your hearing may become hampered in later stages of life and what you can do to manage (and possibly even minimize) it.

Usually affecting both ears, age-related hearing loss is often slow and insidious, and the symptoms may be quite subtle, Dr. Cosetti says. Here are a few signs to look out for:

"In both age-related hearing loss and noise-induced hearing loss, the high frequencies are affected first," Dr. Cosetti says. Which is why "some individuals report difficulty hearing the voices of young children and others with high-pitched voices," she says.

In addition, "consonants such as s, f and h, which help distinguish words, fall in the high frequencies," Dr. Cosetti says. So the "loss of these key sounds leads to difficulty with speech understanding" as well.

Anyone at any age will find it challenging to hear a conversation crystal clear at a boomingly loud rock concert. But if you're noticing that everyday background noise is limiting your listening skills, you're likely dealing with age-related hearing loss.

People with age-related hearing loss "often report a lack of clarity or inability to understand or make out what is being said," Dr. Cosetti says.

"Typically, this is most noticeable in difficult-to-hear environments where there is a significant amount of background noise, such as restaurants, sporting events or public transportation," she adds.

Tinnitus is a common symptom of age-related hearing loss.

"Tinnitus may be tonal, with a ringing sound, but it also may sound like buzzing, hissing, sizzling, wind or a shushing sound, and it can be present in the quiet only or all the time," Dr. Cosetti says.

"Many people report they might hear better if only the noise or tinnitus would abate, not recognizing that the tinnitus itself may be a manifestation of hearing loss," she adds.

Does the sound of the air conditioner suddenly seem shockingly loud? This perception of exaggerated sound is called recruitment, and it's another common symptom of age-related hearing loss, Dr. Cosetti says.

"This phenomenon results from the uneven distribution of hearing loss across the various frequencies in the cochlea," she says.

"As mentioned earlier, in age-related hearing loss, some hair cells degrade earlier than others," Dr. Cosetti says. But the remaining functioning hair cells may respond rapidly to certain sounds, leading you to experience these noises as startlingly loud.

"In general, hearing loss is underrecognized and under-treated," Dr. Cosetti says. But your hearing has a wide-ranging effect on your overall health and ability to function in older age.

Indeed, "a large amount of data has accumulated in the scientific community linking hearing loss to a number of other important markers of health, including cognitive function, balance and falls, physical functioning, depression and social isolation," Dr. Cosetti says. "The data suggests that those with more hearing loss are at a greater risk of significant health problems in each of these domains."

That's why protecting your hearing is hugely important. Here are some smart strategies to safeguard your hearing into your golden years.

Use ear protection such as earplugs or earmuffs "to protect your hearing from loud noises, even those you may find routine, such as the lawn mower, home power tools, indoor exercise classes and home speaker systems," Dr. Cosetti says.

"When at public events, try to avoid or keep your distance from the sound source, such as a loudspeaker at concerts or sporting events," Dr. Cosetti says.

And, once again, when in loud environments, "wear ear protection and try to take intermittent breaks from the noise," she adds.

"Many smartphones have free 'sound level meter' apps that can measure the noise level of your environment," Dr. Cosetti says. "Take the opportunity to become more familiar with the loudness level of your common activities."

Levels at or above 85 dB may put you at risk for hearing loss, she says.

Remember: "Hearing loss is associated with tobacco use, heart disease and diabetes as well as a variety of medications," Dr. Cosetti says. Thus, "eating well, exercising and generally living a healthy lifestyle are some of the best things you can do to lower your risk of hearing loss."

"Age-related hearing loss may begin in mid-life, around age 50, though the serious symptoms may not manifest for years," Dr. Cosetti says. "Talk to your doctor about hearing loss and ask for a hearing test to understand your hearing level and potential risk."