6 Causes of Hearing Loss in Adults

Living with hearing loss is hard. It can be frustrating, socially isolating, and impact self-esteem and confidence in everyday life. Unfortunately, hearing loss often increases with age, with one in three adults affected by some degree of hearing loss. 

Age-related hearing loss is typically sensorineural, which happens when sound cannot reach the inner ear. It can occur suddenly or gradually and generally develops later in life from a range of causes, including infections, ruptures, and loud noise exposure. 

While there is no single cause for hearing loss in adults, there are six common reasons why some adults lose their hearing as they age. 

How common is age-related hearing loss?

Age-related hearing loss, called presbycusis, is one of the most common conditions affecting adults. As we age, changes occur in the inner and middle ear that impact the nerve pathways from the ear to the brain. Exposure to noise over the years also plays a role in hearing loss as it begins to wear down these nerve cells. 

According to the Australian Department of Health and Aged Care, roughly 3.6 million people had some level of hearing loss in 2017, representing 14.5% of the general population. This number is estimated to double to 7.8 million by 2060. Hearing loss increases for 50% of individuals aged between 60 and 70, 70% for those aged 70 and older, and 80% for those aged 80 and over. As we age, it is important to get regular hearing tests to get a consistent gauge on changes to hearing and ensure that, where required, that can be treated by an audiologist.

Signs of Hearing Loss

Hearing loss usually occurs gradually, so the signs may be difficult to notice at first. In fact, the people around you may notice signs of hearing loss before you do. 

The initial signs of hearing loss generally include: 

• Avoiding social outings 
• Difficulty hearing or misunderstanding what people say, especially in noisy places
• Having trouble hearing over the phone
• Asking people to repeat themselves regularly
• Difficulty in keeping up with a conversation
• Feeling tired and stressed from concentrating too hard in conversations or while listening
• Turning up the TV or music louder than others
• Hearing a constant buzzing or ringing in your ears

6 Causes of Hearing Loss in Adults

1. Damage to the inner ear

The inner ear can be damaged by aging and long-term exposure to loud noises. The main function of the inner ear is to convert mechanical signals from the middle ear into electrical signals, transferring information to the auditory pathway in the brain. When the inner ear is damaged, the hair cells that convert and transfer these signals and information to the brain will not work effectively, resulting in permanent hearing loss or tinnitus. 

Aging can result in a damaged inner ear, through wear and tear from exposure to high levels of volume over the years, or from cardiovascular issues that starve blood flow to the hair cells. 

2. Bone remodelling in the middle ear (otosclerosis) 

Otosclerosis is an autoimmune inflammatory disorder caused by abnormal bone remodelling in the middle ear. The middle ear amplifiers sound vibrations and send them to the cochlea, which is found in the inner ear. 

Bone remodelling occurs when bone tissue renews itself by replacing old tissue with new tissue. When otosclerosis occurs, the bone remodelling in the middle ear is abnormal and disrupts sound travel from the middle ear to the inner ear. Otosclerosis may also cause balance issues, like dizziness and vertigo. 

Otosclerosis is most common in females between the ages of 30 and 50 and can be caused by a measles virus infection, anti-collagen autoimmunity, inflammation, bone loss, and hormonal and metabolic factors. 

3. Earwax buildup

Over time, earwax can build up and block the ear canal, preventing sound waves from passing through and causing hearing loss, tinnitus, pain in the ear, and dizziness. Earwax buildup, medically known as cerumen impaction, commonly occurs in adults over the age of 55 who have dry or hard earwax, a lot of ear hair, narrow ear canals, frequently wear earplugs or hearing aids, or routinely use cotton buds to clean the ears. 

4. Ruptured eardrum

A torn or ruptured eardrum is when there is a hole or tear in the eardrum. It can cause hearing loss in adults and can cause sudden hearing loss, sharp pain in the ear, pus or blood coming out of the ear, or tinnitus. 

A ruptured eardrum is most commonly caused by middle ear infections, which cause fluid or pus buildup inside the ear and put pressure on the eardrum. However, a rupture can also develop from frequent use of cotton buds, head trauma, a change in air pressure, and sudden loud sounds or blasts. 

5. Acoustic Neuroma

Acoustic neuroma is a non-cancerous tumour that grows directly on the nerve responsible for hearing and balance, the vestibular nerve, which leads from the inner ear to the brain. Generally, acoustic neuroma tumours grow slowly or not at all.  

Individuals with acoustic neuromas often develop one-sided hearing loss, sensation of fullness in the ear, vertigo, and tinnitus. 

6. Health conditions

Common age-related health conditions that can cause hearing loss include diabetes, high blood pressure, heart condition, or stroke. 

The exact cause of hearing loss and age-related health conditions is unknown. However, some studies have found a connection between hearing loss and changes in blood sugar and pressure, which are common side effects of these health conditions. 

How to Deal with Age-Related Hearing Loss 

If you have noticed hearing loss or someone has expressed concern about your hearing loss, the most important thing to do is to get a hearing assessment by an audiologist. An audiologist will determine the cause and extent of your hearing loss and treat your hearing problems. 

Treatment for hearing loss depends on a case-by-case basis. If your hearing loss is due to wax buildup, you may require routine appointments with your audiologist for regular cleaning. However, if your hearing loss is caused by damage to the inner ear or a ruptured eardrum, hearing aid devices may be needed to live with permanent hearing loss or tinnitus.