Hearing Loss: Changes That Come Over Time

​As most older people can tell you, hearing can start to change as we age.

 

As we get older, keeping every sense functioning well becomes increasingly important. The following sections explore how aging affects hearing, vision, smell, and taste, along with the changes a person can expect over time. Each section includes practical approaches that can help offset or slow these age‑related changes.

 

In an ideal world, we’d all learn healthy habits early and carry them forward as we grow. But that’s not how most of us were taught. Life pushes many of us toward quick fixes and immediate rewards, often at the expense of long‑term health and well-being. We wait until something goes wrong, then try to fix it. The message here? Start taking care of yourself whenever you can —and if you haven’t already, today is a good time to start.

 

Hearing Changes

 

An Overview of Hearing

 

According to the Mayo Clinic, by age 75, nearly half of all older people experience some hearing loss. Of course, hearing loss varies by individual and the conditions they may have encountered in the past.

 

Our hearing is regulated by the following:

1)Outer hair cells (IHC’s) that pick up sound and amplify it.

2) The inner hair cells in the cochlea, which convert vibrations into electrical impulses  

3) Electrical impulses travel down the auditory nerves in the brain

4) Impulses arrive at the frontal lobe of the brain, where they are interpreted.

 

Hearing - What Changes as You Age?

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As we age, the entire hearing system gradually changes. The outer hair cells—that initially sense and amplify sound—tend to weaken first. Over time, the inner hair cells also lose efficiency, and the connections between these cells and the auditory nerve begin to weaken. Eventually, the nerve fibers themselves decline, and even the auditory cortex in the brain can become less sharp at interpreting sound. This process is called presbycusis, and all of these structures can age, but the pace and pattern of change vary widely from person to person.

Some of these changes can be prevented.

 

What contributes to hearing loss besides aging?

 

Many, many other factors can contribute to this as well. The good news is that many of these are within our control, and while hearing loss cannot be cured, some hearing loss can be prevented through certain actions. You can also improve hearing through other means. But, again, you cannot cure hearing loss. The following sections outline these other causes.

 

•  Long-term loud sound exposure

•  Frequent loud machinery or industrial noise

•  Remember your years of listening to loud music? (concerts, headphones, car stereos)

•  Exposure to a lot of wind

 

• Recurrent ear infctions/sinus problems

• Chronic or repeated ear infections

• Chronic sinusitis or allergies affecting the Eustachian tube or vestibular system

 

• Ototoxic medications (medicines known to damage hearing structures)

• Chemotherapy drugs (e.g., cisplatin)

• “Mycin” antibiotics (aminoglycosides)

• Some non-steroidal anti-inflammatories (NSAIDs)

• Certain antifungals

• Diuretics

• Some serotonin reuptake inhibitors (SSRIs)

   

Infections and illnesses (sensorineural damage):

• Meningitis

• Measles

• Mumps

• Rubella

• Syphilis

• HIV

• COVID‑19

• Frequent childhood ear infections

   

• Chronic health conditions (sensorineural loss)

• High blood pressure

• Diabetes

• Cardiovascular disease

• Multiple sclerosis (MS)

• Rheumatoid arthritis (RA)

   

Trauma: 

• head trauma

• ear injury

 

Age-related neurologic or structural conditions:

• Acoustic neuroma (vestibular schwannoma)

• Stroke affecting auditory cortex or brainstem pathways

• Parkinson’s disease

• Alzheimer’s disease

 

   Genetics;

• Family history of early or progressive hearing loss

• Inherited structural or metabolic tendencies affecting the inner ear

   

Clues That You May Have Hearing Loss

People often miss the early signs of hearing loss. Common clues include:

• “What? What??”

  “Honey, you don’t seem to hear what I’m saying.” (Sometimes selective inattention — but often a classic sign of hearing loss)

• Hearing muffled speech or sounds

• Difficulty understanding words, especially in crowds or noisy places

• Asking others to speak more slowly, clearly, or loudly

• Turning up the volume on the TV or radio

• Avoidance of social settings

• Feeling annoyed or overwhelmed by background noise

• Tinnitus (ringing in the ears)

• hearing loss

If you or someone you know seems to be experiencing a hearing loss, it is important to see a healthcare provider. They may refer you to an audiologist.

 

What to do about Chronic and Acute Hearing Loss

It is particularly important to see a healthcare provider for a medical evaluation if you experience:

 

A healthcare provider will typically check for earwax buildup that may be impairing your hearing. Some people just have a tendency toward wax buildup - or cerumen impaction. - but as we age, cerumen becomes drier and harder, making it more likely to accumulate and block the ear canal. This can be safely cleaned out by a healthcare provider or ENT.

 

If wax is minimal, the next step is a hearing evaluation by an audiologist to determine whether true hearing loss is present.

 

How an Audiologist Can Help

An audiologist can test, dicover the cause and offer several options to help improve hearing.

 

Hearing Aids

Modern hearing aids are very small and discreet. Many people also benefit from TV or phone amplifiers.

You can now buy FDA‑regulated over‑the‑counter (OTC) hearing aids for mild to moderate hearing loss. They are more affordable than prescription devices and several models perform well, according to FDA guidance and ConsumerLab reviews.

 

Surgical Options

For certain conditions, an audiologist or ENT may recommend:

• Eardrum repair

• Cochlear implants (which electrically stimulate the auditory nerve) for severe hearing loss

 

Regularly Monitor for Hearing Loss

While it’s ideal to have your hearing checked by an audiologist every year or two, Medicare and most insurance plans usually don't cover routine hearing tests after age 40 unless you have noticeable hearing changes or specific symptoms. These symptoms include tinnitus (ringing in the ears), dizziness or vertigo, persistent ear fullness or pressure, suspected middle‑ear disease, or the need to monitor an existing hearing condition.

 

Even though coverage is limited, regular hearing screenings are still recommended—especially after age 40 or for anyone exposed to loud environments over many years. Early testing allows for early detection and intervention, which can help preserve hearing and prevent long‑term damage.

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