Hearing loss is one of the most common conditions affecting older adults. Approximately 17 percent, or 36 million, of American adults say that they have some degree of hearing loss. Roughly one-third of Americans 65 to 74 years of age and 47 percent of those 75 and older have hearing loss. Men are more likely to experience hearing loss than women.

People with hearing loss may find it difficult to have a conversation with friends and family. They may also have trouble understanding a doctor's advice, responding to warnings, and hearing doorbells and alarms.

Hearing loss comes in many forms. It can range from a mild loss in which a person misses certain high-pitched sounds, such as the voices of women and children, to a total loss of hearing. It can be hereditary or it can result from disease, trauma, certain medications, or long-term exposure to loud noises.

There are two general categories of hearing loss. Sensorineural hearing loss occurs when there is damage to the inner ear or the auditory nerve. This type of hearing loss is permanent.

Conductive hearing loss occurs when sound waves cannot reach the inner ear. The cause may be earwax build-up, fluid, or a punctured eardrum. Medical or surgical treatment can usually restore conductive hearing loss.

One form of hearing loss, presbycusis, comes on gradually as a person ages. Presbycusis can occur because of changes in the inner ear, auditory nerve, middle ear, or outer ear. Some of its causes are aging, loud noise, heredity, head injury, infection, illness, certain prescription drugs, and circulation problems such as high blood pressure.

Presbycusis commonly affects people over 50, many of whom are likely to lose some hearing each year. Having presbycusis may make it hard for a person to tolerate loud sounds or to hear what others are saying.

Tinnitus, also common in older people, is the ringing, hissing, or roaring sound in the ears frequently caused by exposure to loud noise or certain medicines. Tinnitus is a symptom, not a disease, so it can accompany any type of hearing loss.

Tinnitus can also be a sign of other important health problems, such as allergies and problems in the heart and blood vessels. Tinnitus can come and go, or it can persist or stop altogether.

Some people may not want to admit they have trouble hearing. Older people who can't hear well may become depressed or withdraw from others to avoid feeling frustrated or embarrassed about not understanding what is being said. Sometimes older people are mistakenly thought to be confused, unresponsive, or uncooperative just because they don't hear well.

Hearing problems that are ignored or untreated can get worse. If you have a hearing problem, you can get help. See your doctor. Hearing aids, special training, certain medicines, and surgery are some of the choices that can help people with hearing problems. 
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Hearing loss happens for many reasons. Some people lose their hearing slowly as they age. This condition is called presbycusis. Doctors do not know why presbycusis happens, but it seems to run in families.

Another cause is the ear infection otitis media, which can lead to long-term hearing loss if it is not treated.

Hearing loss can also result from taking certain medications. "Ototoxic" medicines damage the inner ear, sometimes permanently. Some antibiotics are ototoxic. Even aspirin at some dosages can cause problems, but they are temporary. Check with your doctor if you notice a problem while taking a medication.

Heredity also is a cause of hearing loss, but not all inherited forms of hearing loss take place at birth. Some forms can show up later in life. In otosclerosis, which is thought to be a hereditary disease, an abnormal growth of bone prevents structures within the ear from working properly. A severe blow to the head also can cause hearing loss.

One of the most common causes of hearing loss is loud noise. Loud noise can permanently damage the inner ear. Loud noise also contributes to tinnitus, which is a ringing, buzzing, or roaring sound in the ears.

Already, 26 million American adults between 20 and 69 years of age have permanently damaged their hearing due to exposure to loud noise at work or in leisure activities.

Noise-induced hearing loss is 100 percent preventable. You can protect your hearing by avoiding noises at or above 85 decibels in loudness, which can damage your inner ear. These include gas lawnmowers, snowblowers, motorcycles, firecrackers, and loud music.

Lower the volume on personal stereo systems and televisions. When you are involved in a loud activity, wear earplugs or other hearing protective devices. Be sure to protect children as well.

Although awareness of noise levels is important, you should also be aware of how far away you are from loud noise and how long you are exposed to it. Avoid noises that are too loud (85 decibels and above), that are too close, and that last too long. If you experience tinnitus or have trouble hearing after noise exposure, then you have been exposed to too much noise.

There are other ways to prevent hearing loss. If earwax blockage is a problem for you, ear, nose, and throat doctors recommend using mild treatments such as mineral oil, baby oil, glycerin, or commercial ear drops to soften earwax. If you suspect that you may have a hole in your eardrum, however, you should consult a doctor before using such products. A hole in the eardrum can result in hearing loss and fluid discharge.

The ear infection otitis media is most common in children, but adults can get it, too. You can help prevent upper respiratory infections -- and a resulting ear infection -- by washing your hands frequently. Also, get a flu shot every year to help stave off flu-related ear infections. If you still get an ear infection, see a doctor immediately before it becomes more serious.

Do you take medication? If so, ask your doctor if your medicine is ototoxic, or damaging to the ear. Ask if other drugs can be used instead. If not, ask if the dose can be safely reduced. Sometimes it cannot. However, your doctor will help you get the medicine you need while trying to reduce unwanted side effects. 

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Some people may have a hearing problem without realizing it. Others might think they have a problem, but are too embarrassed to tell their doctor, friends, or family. You can help identify a possible hearing problem by asking yourself some key questions and, if necessary, having your hearing checked by a doctor. Only 38 percent of adults ages 70 years and older and only 29 percent of adults ages 20 to 69 have had their hearing tested within the last 5 years.

If a hearing loss is ignored or untreated, it can get worse. But a hearing loss that is identified early can be helped through treatment, such as hearing aids, certain medicines, and surgery.

Ask yourself the following questions. If you answer "yes" to three or more of these questions, you could have a hearing problem and may need to have your hearing checked by a doctor.

• Do I have a problem hearing on the telephone?
• Do I have trouble hearing when there is noise in the background?
• Is it hard for me to follow a conversation when two or more people talk at once?
• Do I have to strain to understand a conversation?

• Do many people I talk to seem to mumble or not speak clearly?
• Do I misunderstand what others are saying and respond inappropriately?
• Do I often ask people to repeat themselves?
• Do I have trouble understanding the speech of women and children?

• Do people complain that I turn the TV volume up too high?
• Do I hear a ringing, roaring, or hissing sound a lot?
• Do some sounds seem too loud?

If you think that you have a hearing problem, schedule an appointment with your family doctor. In some cases, he or she can identify the problem and prescribe treatment.

Your doctor may refer you to an otolaryngologist. This doctor and surgeon has special training in problems of the ear, nose, throat, head, and neck.

An otolaryngologist will try to find out why you have a hearing loss and offer treatment options. He or she will ask you for your medical history, ask if other family members have hearing problems, do a thorough exam, and prescribe any needed tests.

Your doctor may also recommend that you visit an audiologist. An audiologist is a health professional who can identify and measure hearing loss. The audiologist will use a device called an audiometer to test your ability to hear sounds of different pitch and loudness.

The tests that an audiologist performs are painless. Audiologists do not prescribe drugs or perform surgery. If you need a hearing aid, an audiologist can help you choose the right one.

Sudden sensorineural hearing loss, or sudden deafness, is a rapid loss of hearing. It can happen to a person all at once or over a period of up to 3 days. It should be considered a medical emergency. If you or someone you know experiences sudden sensorineural hearing loss, you should visit a doctor immediately. 
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