Written by Caroline Amin, MD | Reviewed by Patricia Pinto-Garcia, MD, MPH

Published on October 1, 2024print_outlinedemail_outlined

Key takeaways:

Age-related hearing loss (presbycusis) affects 1 in 3 adults over 65 years old. But hearing changes can start in your mid-40s.
Early signs of age-related hearing loss can be easy to miss. Feeling tired, stressed, or like you can’t keep up during conversations are common signs of early hearing loss.
Hearing aids can help you hear better and get you back to your usual social and work routines.

Older woman places a smartphone to her ear. pocketlight/E+ via Getty Images

It’s normal to develop trouble hearing as you get older. In fact, about 1 in 3 adults over 65 years old have trouble hearing. But people can start developing hearing changes as early as their mid-40s.

Age-related hearing loss, or presbycusis, can affect your daily life in many ways. People with hearing loss may struggle to keep up at work. They might also avoid social situations because of trouble hearing. In addition, untreated hearing loss can increase your risk for developing dementia and put you at risk for accidents and injuries.

Luckily, there are safe and effective treatments for age-related hearing loss. But in order to start these treatments, you need to know that you have trouble hearing in the first place. And early signs of hearing loss can be easy to miss.

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Here are four signs you may be developing age-related hearing loss.

1. You’re having trouble keeping up

If you have hearing loss, you may find it hard to keep up with conversations. You might lose the thread of a conversation easily, because you’re missing parts of what’s being said.

This tends to be more of a problem in group situations, when two or more people are talking at the same time. The different pitches of people’s voices can make it hard to understand what one person is saying over another.

2. Conversations tire you out

At first, you may not notice that you’re having trouble hearing people speak. Instead, you might notice that it takes more effort and “brain power” to listen to or understand a conversation.

The increased effort could make you feel more fatigued. And engaging in work or social activities could take more mental effort. This can be draining when it happens regularly. Research also suggests that this higher mental effort can affect your memory and ability to concentrate.

You may find yourself avoiding situations that require a lot of active listening. You may also find it hard to complete work assigned during meetings because you didn’t hear the directions.

The increased effort can also strain social relationships too. You may find yourself asking people to repeat themselves often. This may give the impression that you’re not paying attention when, in reality, it’s because you can’t hear what they’re saying.

3. You avoid using the phone

Audio-only conversations are particularly challenging for people with hearing loss. Face-to-face and video conversations can offer visual cues that help you follow along in a conversation. For example, you may not be able to clearly make out what someone is saying, but you can see when they stop talking. This prompts you to start speaking.

These cues aren’t there when you’re talking with someone on the phone. This can lead to awkward silences and jagged conversations.

Also, certain sounds become harder to hear with hearing loss. People with higher-pitched voices, especially children, can be difficult to understand, even with mild hearing loss. If you find yourself avoiding phone calls, or have a hard time hearing children on video chat, it could be a sign that you have early hearing loss.

4. You’re always turning up the volume

Increasing the volume on the television and other electronic devices is a natural way to compensate for hearing loss. But that rise in volume progresses slowly.

At first, you may only turn the volume up one or two clicks. But over time, you may find yourself turning it up even more. You might not notice how loud your phone or TV is until someone else points it out to you.

Make a note if a family member or friend comments on the volume of your devices. This can be the first sign that you’re developing early hearing loss.

How quickly does hearing loss progress?

Age-related hearing loss progresses slowly over time. Studies estimate that people lose about 1 decibel of hearing per year if they have presbycusis. For reference, a loss of 20 decibels is considered mild hearing loss.

So, people who start having hearing loss in their early 40s may already have moderate hearing loss by the time they seek care in their late 60s.

But other factors can also impact how quickly hearing loss progresses, including:

Loud noise exposure
Ear infections
Exposure to medications that harm hearing
Genetics

If you’re exposed to one or more of these things, your age-related hearing loss may progress faster.

The good news is that treatment can slow down hearing loss. A full hearing evaluation — also known as an audiology exam or audiometry — can show if you have any hearing loss. If you do have hearing loss, treatment options include assistive-listening devices, like:

Hearing aids
Phone amplification devices
Closed-loop devices

Your audiology team can also help you address any other hearing concerns. For example, they can provide you with hearing protection devices to use at work if you’re regularly exposed to loud noises.

When should you seek care for early signs of hearing loss?

It’s important to get care for your hearing loss as soon as possible. People usually wait too long before asking for help. On average, people wait 7 years before seeking treatment. During that time, hearing loss can take a toll on your job performance, relationships, health, and safety.

So get help if you think you’re having trouble hearing. Don’t wait until your symptoms get worse. Getting treatment can help you return to your normal life and keep you safe and healthy.

The bottom line

Age-related hearing loss can start in your mid-40s and affect your physical and mental health. It’s important to recognize the early signs of hearing loss, so you can get the help you need. These signs include things like trouble following along with conversations and needing to turn up the volume on devices. Seek care if you think you have hearing loss. Early treatment can slow down the process and keep you healthy.

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Caroline Amin, MD

Written by:

Caroline Amin, MD

Dr. Amin started her post-education career as a general pediatrician in an urban setting, and an assistant professor of pediatrics at University of Connecticut. In addition to managing care of pediatric patients, she precepted residents and educated rotating medical students.

Patricia Pinto-Garcia, MD, MPH

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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References

Cheslock, M., et al. (2023). Presbycusis. StatPearls.

Government of Australia Health Direct. (2022). Hearing loss.

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GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

4 Early Signs of Hearing Loss You Don’t Want to Ignore