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JAMA Patient Page
March 21, 2012

Adult Hearing Loss

JAMA. 2012;307(11):1215. doi:10.1001/jama.2012.185

As adults age, they can develop hearing loss, which can be partial (hearing impairment) or complete (deafness). Conductive hearing loss is caused by obstruction of or mechanical damage to the outer or middle ear. Sensorineural hearing loss is usually permanent and is caused by damage to the auditory nerve (a nerve that relays hearing information to the brain) or the inner ear. Presbycusis refers to age- associated sensorineural hearing loss and is the most common cause of hearing loss in older adults. In 2008, 31% of Americans older than 65 years had presbycusis and 70% older than 85 years had presbycusis. Risk factors for hearing loss include chronic exposure to loud machinery or music, chronic ear infections, increasing age, and genetic predisposition (passed on from parents to children).

Symptoms and evaluation

People may have hearing loss if they

  • Cannot hear someone talking close by.

  • Have a hard time hearing conversations in crowds.

  • Need to listen to the television at louder volumes than everyone else in the room.

  • Complain of ringing in their ears.

  • Frequently ask others to repeat what they just said.

When patients present with hearing loss, their doctors may

  • Examine both ears to rule out problems that could lead to conductive hearing deficits, such as ear wax, ear infections, or perforated (torn) eardrums.

  • Refer them to otolaryngologists, doctors who specialize in care of the ears, nose, and throat.

  • Refer them to audiologists, who perform hearing tests and fit hearing aids.

If these evaluations have normal results or patients have other symptoms in addition to hearing loss, doctors may request a computed tomography (CT) scan or magnetic resonance imaging (MRI).


Once hearing loss is diagnosed, the evaluation by an audiologist or otolaryngologist will help determine what treatment is best.

  • Surgery can be used to correct conductive causes of hearing loss.

  • Hearing aids can be used to treat partial sensorineural hearing loss. Hearing aids are small devices that fit inside or behind ears. They pick up sounds and amplify them to make them louder to the eardrum.

  • Cochlear implants are usually used by people with severe or complete hearing loss. These devices are inserted surgically into the inner ear and electrically stimulate the auditory nerve.

For more information

Inform yourself

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA 's website at www.jama.com. Many are available in English and Spanish.

Sources: Mayo Clinic, Cleveland Clinic

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