Introduction
Imagine you take your car to the mechanic because it’s making a funny noise. If the mechanic simply said, “You have car trouble,” you would probably be frustrated. You would want to know: Is it the engine? The tires? The brakes?
The same logic applies to your ears.
When a doctor tells you or a loved one that you have hearing issues, it is easy to assume it is all the same thing. But the truth is, there are several different types of age related hearing loss. Some affect how you hear volume, while others affect how you understand clarity. Some are caused by the nerves, while others are caused by the tiny bones in your ear stiffening up.
Understanding exactly what type of hearing loss is caused by aging in your specific case is the key to finding the right solution. It changes the way you treat it, the hearing aids you buy, and the way you communicate with family.
In this guide, we will break down the complex medical terms into plain English. We will explore the specific types of age related hearing loss so you can stop guessing and start understanding your health.
The Big Picture: The Two Main Categories
Before we dive into the specific changes that happen with age, we need to look at the two main umbrellas under which all hearing loss falls.
1. Sensorineural Hearing Loss
This is the most common among seniors. It happens when there is damage to the inner ear (cochlea) or to the nerve pathways from the inner ear to the brain.
- Is it permanent? Usually, yes.
- Can it be treated? Yes, typically with hearing aids.
2. Conductive Hearing Loss
This happens when sound cannot get through the outer or middle ear. It could be a blockage of earwax, fluid, or a perforated eardrum.
- Is it permanent? Not always. It can often be treated medically or surgically.
Most types of hearing loss in older adults are Sensorineural, but it is possible to have both at the same time. This is called Mixed Hearing Loss.
For a broader overview of how hearing loss happens, check out this guide on The Complete Guide to Hearing Loss in Seniors.
Presbycusis: The “Aging Ear”
The medical term for age-related hearing loss is Presbycusis. It is the slow loss of hearing that occurs as we grow older. But here is where it gets interesting: Presbycusis isn’t just one single thing.
Researchers and audiologists have identified several distinct types of age related hearing loss within Presbycusis. Knowing which one you have can explain why you might hear low noises but not high ones, or why you can hear people talking but can’t understand the words.
Here are the four specific sub-types you should know about.
1. Sensory Presbycusis (High-Frequency Loss)
This is arguably the most common of the types of age related hearing loss. It is caused by the loss of sensory hair cells at the base of the cochlea (inner ear).
- What it feels like: You lose the ability to hear high-pitched sounds. You might hear a truck rumbling by (low pitch) perfectly fine, but you miss the microwave beeping or the birds chirping (high pitch).
- The Communication Struggle: You will likely say, “I can hear you talking, but you are mumbling.” This is because you are missing the crisp consonant sounds like S, F, Th, and K.
- Best Solution: Hearing aids that focus on amplifying high frequencies while leaving low frequencies alone.
Does this sound like you? Read our article on 5 Early Signs of Hearing Loss to see if you have the symptoms of Sensory Presbycusis.
2. Neural Presbycusis (Loss of Clarity)
Among the types of age related hearing loss, this one can be the most frustrating. It is caused by the loss of nerve fibers in the auditory nerve. Essentially, the “wire” connecting your ear to your brain is fraying.
- What it feels like: Volume isn’t the main issue; processing is. Even if someone shouts, the words might still sound garbled.
- The Communication Struggle: You might struggle immensely in background noise. The brain can no longer separate speech from the clatter of dishes in a restaurant.
- The Statistic: This type affects about 30-40% of seniors with hearing loss, often starting later in life (70s and 80s).
3. Metabolic (Strial) Presbycusis
Your inner ear needs a power supply to work. This comes from a structure called the stria vascularis, which provides blood flow and bioelectricity to the cochlea. As we age, this blood supply can weaken.
- What it feels like: Unlike the other types of age related hearing loss, this usually causes a “flat” hearing loss. This means you lose hearing across all pitches equally—low, middle, and high.
- The Genetic Link: This type often runs in families. If your mother had hearing loss in her 60s, this might be what type of hearing loss caused by aging in your case, too.
- Good News: Because the clarity of speech is often preserved (everything is just quieter), people with this type tend to do very well with hearing aids.
4. Mechanical (Cochlear Conductive) Presbycusis
This occurs when the physical structures inside the inner ear stiffen up. The tiny membrane that vibrates to create sound becomes rigid over time, making it harder for it to move.
- What it feels like: A gradual slope of hearing loss. It gets harder to hear as the pitch gets higher, but it is not as sharp of a drop-off as Sensory Presbycusis.
- Impact: It is a mechanical issue, much like stiff joints, but inside your ear.
Other Types of Hearing Loss in Older Adults
While Presbycusis covers the natural aging process, there are other types of hearing loss in older adults that can strike at the same time. It is important for caregivers to watch for these, as they might require different treatments.
Sudden Sensorineural Hearing Loss (SSHL)
This is a medical emergency. If you wake up one morning with a “popped” ear or sudden deafness in one ear, go to the ER or an ENT immediately. This is not one of the normal types of age related hearing loss. It could be a virus or a circulatory issue, and it needs to be treated with steroids within days to save your hearing.
Noise-Induced Hearing Loss
This is damage caused by a lifetime of noise—factory work, hunting, loud music, or military service. While it is technically different from aging, it almost always compounds with age-related hearing loss.
- Symptom: A common sign is a “notch” in your hearing test where you specifically cannot hear sounds at 4,000 Hz.
Tinnitus (The Phantom Sound)
While not technically a “hearing loss,” Tinnitus (ringing in the ears) almost always accompanies the various types of age related hearing loss. It is your brain trying to create sound because the ear isn’t sending enough signals.
If you are a caregiver trying to explain these types to a parent, check out our guide on How to Talk to Parents About Hearing Aids.
Solutions for Different Types
Why does knowing these types of age related hearing loss matter? Because it dictates the solution. Not all hearing aids work for all people.
For Sensory Loss (High Frequency)
You need “Open Fit” or Receiver-in-Canal (RIC) hearing aids. These keep your ear canal open so you can hear low tones naturally, while the hearing aid only boosts the high tones.
- Top Pick: The Jabra Enhance or Phonak Audéo series are excellent for this specific profile.
- [Check out our review of the Best Hearing Aids for Seniors here]
For Metabolic Loss (Flat Loss)
You may need more power across the board. In-the-Ear (ITE) or custom-molded hearing aids often work best here because they seal the ear to provide volume for low and high pitches alike.
- Budget Option: Simple amplifiers like the Audien Atom can actually work reasonably well for flat loss, as they amplify everything equally.
For Neural Loss (Clarity Issues)
Volume alone won’t help. You need hearing aids with advanced Artificial Intelligence (AI) and noise reduction. You need a device that cleans the sound before it hits your ear.
- Recommendation: Look for premium prescription devices like the Oticon Intent, which uses deep neural networks to process sound.
Tips for Managing Age Related Hearing Loss
Regardless of which of the types of age related hearing loss you are facing, there are universal best practices to keep your ears—and your brain—healthy.
- Get a Differential Diagnosis: Don’t just settle for “you have hearing loss.” Ask your audiologist: “Which of the types of age related hearing loss do I have? Is it sensory or neural?”
- Use Assistive Listening Devices: If you have Neural Presbycusis, hearing aids might not be enough in a crowded room. Use a remote microphone (a small mic your spouse wears) to beam their voice directly to your ears.
- Diet Matters: For Metabolic Presbycusis, blood flow is key. A heart-healthy diet rich in leafy greens and low in sodium can help preserve the stria vascularis (the ear’s battery).
- Brain Training: Because some types of age related hearing loss involve the nerves and brain, “auditory rehabilitation” (listening exercises) can help you relearn how to process words.
Conclusion
Hearing loss is complex. It is a mix of biology, genetics, and environment. But knowing that there are distinct types of age related hearing loss should be empowering, not scary. It means there isn’t just one generic path to decline; there are specific, targeted ways to manage your unique situation.
Whether you have sensory loss and just need clarity, or metabolic loss and need volume, the technology exists today to help you stay connected.
Don’t let the confusion stop you from seeking help. The first step is understanding what you are dealing with.
Ready to find out more?
- [Download our Free Senior Hearing Checklist] to take to your next audiologist appointment.
- [Browse our Top Rated Hearing Aids] to see which devices are best for your specific type of hearing needs.
