Age-related hearing loss, known as presbycusis, is caused by gradual wear and tear on the tiny sensory hair cells in the cochlea, the hearing organ in your inner ear. Other things can add to it, including years of loud noise, inherited traits, certain health conditions, some medicines and smoking. It cannot be reversed, but hearing aids help many people a great deal.
I have worked as an audiologist for 38 years, and in private practice here in Lincoln since 2007. Almost every week, someone sits down in my consulting room and asks me why their hearing has changed, often with a worried look, as though they have done something wrong. In the great majority of cases they have not. Age-related hearing loss is the most common cause of hearing loss there is, and most of us will experience some level of it. Understanding what is happening inside the ear makes it far less mysterious, and it makes the next step easier to take.
Wondering whether your own hearing has started to change? A hearing test with me will show you exactly where you stand. Call 01522 567081 or visit my contact page.
What is age-related hearing loss?
Age-related hearing loss, or presbycusis, is a gradual reduction in hearing that develops as we get older. It usually affects both ears to a similar degree. Because it comes on slowly, over years rather than weeks, many people do not notice it at first. Friends and family often see it before the person experiencing it does.
RNID describes the cause as gradual wear and tear on the hair cells in the cochlea. Those hair cells pick up sound vibrations and turn them into signals that travel to the brain. Once they are damaged or lost, they do not grow back, and that is why this type of hearing loss is permanent.
What happens inside the ear as we age?
The cochlea is a small, snail-shaped structure in the inner ear, lined with tiny hair cells that respond to different pitches. Over a lifetime, higher-pitched sounds are usually affected first, while lower-pitched sounds often hold up for longer.
This is why age-related hearing loss has such a recognisable pattern. Voices are still audible, but certain speech sounds become harder to tell apart. Consonants such as s, f and th carry much of the clarity in speech and sit in the higher pitches, so words begin to sound muffled or unclear. People seem to mumble, even though they have not changed. I see this pattern on audiograms every week, and it is one of the reasons a hearing test is so useful. It shows exactly which pitches have been affected, rather than leaving you to guess.
What other things contribute to hearing loss with age?
Wear and tear on the hair cells is the core cause, but it does not happen in isolation. Johns Hopkins Medicine lists several factors that can contribute to age-related hearing loss:
- Long-term exposure to loud sound, whether from music or from work
- Inherited traits, so that hearing loss tends to run in some families
- Health conditions such as heart disease and diabetes
- Side effects from some medicines, including aspirin, certain chemotherapy drugs and some antibiotics
- Infections
- Smoking
This is part of why two people of the same age can have very different hearing. Someone who spent decades on a noisy factory floor or a farm, or who played in a band, may notice changes sooner than someone who has lived a quieter life. Family history matters too. When a patient tells me a parent or grandparent was hard of hearing, I am not surprised to see early changes on their audiogram.
None of this means you did anything wrong. Most of these factors are part of ordinary life and work, and many are outside anyone’s control.
What are the signs of age-related hearing loss?
RNID lists the signs of age-related hearing loss as:
- Other people seeming to mumble
- Often needing things repeated
- Trouble understanding speech in noisy places
- Difficulty following group conversations
- Feeling tired from concentrating so hard
- Other people finding your television or music too loud
- Trouble hearing on the phone
Many people also notice ringing in their ears, known as tinnitus, which is often linked to hearing loss. If you recognise several of these, the next step is a hearing test.
Recognising some of these signs? Book a hearing test with me in Lincoln. Call 01522 567081 or get in touch here and we can find a time that suits you.
Can age-related hearing loss be prevented or reversed?
There is currently no way to restore hearing once age-related hearing loss has happened, and this is a point I am always honest about with patients. Once the hair cells in the cochlea are damaged or lost they do not grow back, so the change is permanent.
What you can do is protect the hearing you have. Limiting exposure to loud noise matters, and so does turning down the volume on headphones and earbuds, wearing ear protection when you are around loud machinery or music, avoiding smoking and getting ear infections treated promptly. A 2026 article from Penn State Health recommends hearing protection above 85 decibels, and earplugs or earmuffs with a Noise Reduction Rating of at least 22 decibels. That is useful advice for anyone who spends time around power tools, lawnmowers, live music or shooting.
It is also worth having your ears checked for something simple. A build-up of ear wax can make hearing worse and is easy to mistake for ageing. I always look in the ears first for this reason, because if wax is part of the picture, that part can be put right.
How is age-related hearing loss treated?
For most people, hearing aids are the most effective treatment. RNID is clear that although hearing cannot be restored, many people find hearing aids very helpful. A hearing aid makes up for the sounds your ear is no longer picking up, and modern devices do this with remarkable subtlety, even though the hair cells themselves stay as they are.
Hearing aid technology has moved on considerably in the last couple of years. Many current hearing aids use AI processing that has been trained on large libraries of real-world sound, so that the device can tell speech from background noise and give more attention to the voices you are trying to follow. That matters, because difficulty with conversation in noise is one of the first things people notice. Auracast is also arriving across the major manufacturers, and it allows compatible hearing aids to receive audio directly from venues and sources that support it.
As an independent hearing aid consultant, I am not tied to any brand, and I specialise in the latest AI hearing aids and Auracast-enabled devices from all manufacturers. That means I can choose between them on the strength of your hearing, your lifestyle and your preferences, rather than starting from what one company happens to make. Other support can help alongside hearing aids, such as facing people when they speak, choosing quieter places to talk and making use of subtitles on the television.
When should you act on it?
Sooner tends to be better than later. RNID notes that untreated hearing loss can lead to social isolation, and acting early means you can stay in the conversations, gatherings and phone calls you enjoy, rather than gradually drifting out of them. It also gives you a record of your hearing to compare against in future.
If your hearing has changed suddenly, in one or both ears, that is different from the gradual change described here. Contact NHS 111 or your GP urgently, or visit your nearest urgent treatment centre.
For gradual change, the starting point is simply to find out. A hearing test with me includes a conversation about what you have noticed, a look inside your ears, a listening test using headphones and a clear explanation of your results. If everything is within a normal range, that is useful to know. If you have hearing loss, we can talk through your options at a pace that suits you.
Ready to take the first step? Book a hearing test with me in Lincoln today. Call 01522 567081 or arrange an appointment through my contact page.
FAQs
What is the main cause of age-related hearing loss?
The main cause is gradual wear and tear on the sensory hair cells in the cochlea, in the inner ear. These cells turn sound vibrations into signals for the brain, and once they are damaged they do not grow back.
At what age does hearing loss usually start?
There is no single age. Hearing loss increases as you get older, and most people experience some level of it. RNID reports that more than half of the UK population over 55 has some hearing loss, but it can start earlier, particularly where there has been a lot of noise exposure or a family history.
Can age-related hearing loss be reversed?
No. There is currently no way to restore hearing lost to age-related changes in the inner ear. However, many people find that hearing aids make a significant difference, and protecting your hearing from loud noise helps avoid further damage.
Which sounds are affected first?
Higher-pitched sounds are usually affected first, including some voices and speech sounds such as s, f and th. That is why many people feel that others are mumbling even though they can hear that someone is speaking.
