Fragility and Presbycusis

Aging and the needs of older people: Health strategies for healthy aging

ISBN: 978-84-09-30541-4

Manuel Manrique

Age-related hearing loss: Presbycusis

Age-related hearing loss, also known as presbycusis, is a decrease in hearing ability that happens with age to most people. It is one of the most common conditions suffered by older people. Some 30% of men and 20% of women in Europe suffer a hearing loss of 30 dB or greater by age 70, and 55% of men and 45% of women at age 80, according to Roth et al1. Approximately a third of the people affected by this in Europe suffer a disabling hearing loss. It is estimated that the hearing loss of some 900,0002 individuals is severe enough to opt to a cochlear implant (CI).

Presbycusis is a significant communication disorder, involving not just a peripheral component (cochlea), but also a core component. This means that patients have difficulty understanding spoken language. Even though their audibility or hearing perception is sufficient, they cannot understand acoustic stimuli with complex patterns (language, music), particularly in noisy environments. The speed of processing within the central nervous system and the timing of the integration of afferent information are altered. Additionally, loss of inhibitory control and spatial memory have been observed, as a result of the loss of sensory nerve cells (hair cells) and the progressive sensory deprivation3. Central presbycusis must be seen as an underrated factor responsible for disrupting the inter-human communications of older people, which often gives way to social isolation and subdepression. The lack of auditory input is linked to cognitive impairment as well, and in some extreme cases, to age-related dementia4. Some epidemiological studies show that the risk of developing central presbycusis increases by 4-9% with every year of age (starting at around age 55). The prevalence among men is greater5. Because of all this, hearing loss has broad impact on the quality of life of older adults6. Some recent research suggests that, over time7, people with hearing loss are more susceptible to Alzheimer’s disease or any other form of dementia, and that the age-related hearing impairment is a potentially revertible risk factor that can reduce the severity of the dementia and the Alzheimer’s disease8.


  1. Roth TN, Hanebuth D and Probst R. Prevalence of age-related hearing loss in Europe: a review. Eur Arch Otorhinolaryngol 2011 Aug; 268(8): 1101–1107.
  2. Stevens GA, Flaxman S, Brunskill E, Mascarenhas M et al. Global and regional hearing impairment prevalence: an analysis of 42 studies in 29 countries. The European Journal of Public Health 2011. doi: 10.1093/eurpub/ckr176
  3. Frisina RD, Walton JP. Age-related structural and functional changes in the cochlear nucleus Hear Res 2006; 216-217:216-23.
  4. Kricos P. Audiologic management of older adults with hearing loss and compromised cognitive/psychoacoustic auditory processing capabilities. Trends Amplific 2006;10:1-28.
  5. Golding M, Taylor A., Cupples L, Mitchell P. Odds of Demonstrating Auditory Processing Abnormality in the Average Older Adult: The Blue Mountains Hearing Study. Ear and Hearing 2006; 27:129-138.
  6. Chia EM, Wang JJ, Rochtchina A, Cumming RR, Newall P, Mitchell P. Hearing impairment and healthrelated quality of life: The Blue Mountains hearing study. Ear and Hearing 2007; 25: 187-195.
  7. Albers K. Hearing Loss and Dementia: New Insights. MM (2012).
  8. Panza F, Solfrizzi V, Logroscino G. Age-related hearing impairment—a risk factor and frailty marker for dementia and AD. Nat Rev Neurol 2015.