Is Your TV On ‘Boom’ Level? Get Help for Poor Hearing In Older Age

Some things have become so associated with aging that people barely question them anymore — misheard conversations, TV volume slowly creeping higher and higher over the years, or answering a question that wasn’t quite what was asked.

Hearing loss is often treated as just another normal part of growing older. But is it really something we should simply accept?

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Hearing and Old Age

Like volume, hearing has a range. The human ear can detect sounds as soft as about 0 decibels — like rustling leaves — to about 120 to 130 decibels, which is as loud as a jet engine and can be painful. For context, a whisper is about 30 decibels, and casual conversation is around 45 to 60 decibels. 

In the same way, hearing loss occurs in ranges.  You’re said to have hearing loss if you don’t hear as well as someone with normal hearing — defined as hearing 20 decibels or better in both ears. Age-related hearing loss, also called presbycusis, refers to the gradual decline in hearing that occurs with age. In the United States, about one in three people ages 65 to 74 has hearing loss and nearly half of those older than 75 have difficulty hearing.

Generally, age-related hearing loss affects both ears and happens gradually. High-pitched sounds are usually lost first, such as “s,” “f,” and “th.” Sounds may seem loud but unclear, and many people find it especially hard to understand speech in noisy places. You may catch yourself saying, “I can hear you, but I can’t understand you,” “Restaurants are the worst,” or simply saying “what?” more often than you’d like. This is because age-related hearing loss is often a clarity problem, not just a volume problem. 

Other common signs that you have problems with hearing include:

• trouble hearing on the phone
• difficulty following conversations when more than one person is talking
• frequently asking people to repeat themselves
• turning the TV up louder than others prefer
• trouble hearing in background noise
• thinking others are mumbling
• difficulty hearing higher-pitched voices like children’s voices
• certain sounds seeming overly loud
• ringing in the ears

“Hearing loss is very treatable in later life.”

Frank Lin, professor, Johns Hopkins University School of Medicine

What Causes Hearing Loss in Older Adults?

Hearing loss doesn’t just happen in one spot. It often begins with damage in the inner ear, where tiny hair cells convert sound into nerve signals for the brain. When these hair cells are damaged or die, they do not grow back, which is why age-related hearing loss is usually permanent.

Even a 30-year-old has already lost some of the outer hair cells that detect higher-pitched sounds,” said Dr. Ronna Hertzano, an associate professor at the University of Maryland School of Medicine. Unfortunately, it’s very easy to damage these cells. “Simply exposure to sound, especially loud ones, eventually causes damage to these cells.”

Over time, hearing loss can also involve the hearing nerve and the brain’s sound-processing centers, which is why understanding speech — especially in noisy places — often becomes difficult.  Hearing loss is also influenced by lifetime factors such as noise exposure, diabetes, high blood pressure, heart disease, smoking, and certain medications that can damage the inner ear. Age-related hearing loss also tends to run in families, with about half the susceptibility linked to genetics.

Some hearing problems, however, are not permanent. Earwax or fluid buildup can block sound from reaching the inner ear, and a ruptured eardrum can interfere with how sound vibrations are transmitted. In these cases, treating the blockage or the underlying problem can improve hearing.

Hearing Decline Common, Poor Hearing Isn’t Something to Ignore

So to answer the question: some hearing decline is common with age, but poor hearing is not something you should simply accept or ignore.

One reason hearing loss is often overlooked is that it develops slowly. Many people don’t notice it themselves. In fact, only about 1 in 5 of older adults with significant hearing loss believe they have a hearing problem  But untreated hearing loss doesn’t just affect hearing. It affects communication, daily function, and overall health. Hearing loss has been linked to social isolation, depression, increased risk of falls, and faster cognitive decline.

Treating hearing loss — through hearing aids or other devices — has been associated with a lower risk of long-term cognitive decline compared to leaving hearing loss untreated. Hearing also affects safety. If you can’t hear alarms, traffic, or someone calling out to warn you, it can put you at risk at home and outside.

The bigger problem, therefore, is not that hearing changes with age — it’s that many people assume nothing can be done, when in reality, many treatments and devices can help people hear and function better. Age-related hearing loss cannot usually be reversed, but it can be managed. Hearing aids, assistive listening devices, training, and in some cases implants can significantly improve communication and quality of life.

One trial showed how hearing aids slowed cognitive decline by nearly half in older adults at high risk of dementia.

“Hearing loss is very treatable in later life,” Frank Lin, professor, Johns Hopkins University School of Medicine, and lead author of the study, said in a press release, adding that this makes it an important health target along with other risk factors tied to dementia, like less education in early life, high blood pressure, social isolation and physical inactivity.

What You Can Do

While experts still don’t know how to completely prevent age-related hearing loss, you can protect your ears from noise-induced damage by:

• Moving away from loud sounds
• Turning down the volume on TVs, phones, and music devices — especially when using headphones or earbuds
• Wearing earplugs or protective earmuffs in loud environments such as concerts, construction sites, fireworks displays, or when using loud equipment like lawn mowers or motorcycles

Just as importantly, if you notice signs of hearing loss, get your hearing checked. Hearing loss may be common — but struggling to hear and missing out on conversations and daily life is not something you simply have to live with.