Presbyakusis (Altersschwerhörigkeit): Definition, Symptome & Ursachen

What is presbycusis (age-related hearing loss)?

Every seventh adult in Germany is affected, from 65 years even every second. The speech is from Presbyakusis, thus the age hearing loss. How it comes to it, what the consequences are and what you can do about it, you can learn here.

Presbycusis Definition: Age-related hearing loss

Presbycusis is the medical term for age-related hearing loss. The natural aging process affects not only the hair cells in our inner ear, but also the auditory nerve and our hearing center. As a result, hearing loss typically occurs in the high frequency range. Illness, stress or high noise exposure exacerbate the wear and tear on hearing, which usually begins after the age of 50.

Presbycusis Causes

For us to perceive a sound, a multi-layered process occurs in our ears: Sound travels through the air and is transmitted from our pinna through our ear canals to our eardrum. The vibrations of the eardrum are in turn transmitted from our middle ear to the inner ear.

In the inner ear, also called the cochlea, there are many small hair cells. When a sound wave arrives, the hair cells register movement and report this to our brain. In the lowest part of the cochlea, the hair sensory cells are located, which are responsible for the perception of high-pitched sounds. The higher the cells are positioned on the cochlea, the lower the sounds that are transmitted through them. That is, all signals, whether high or low, pass at the very bottom of the base.

The process resembles a stairwell: Even if I want to get to the second, third or fourth floor, I walk across the carpet on the first floor. Over the years, this leaves its mark on the carpet, most noticeably right at the entrance on the first floor. Like the carpet, the hair sensory cells, which are located at the bottom and register high tones, wear out the fastest. The upper ones are less stressed in comparison. Over the years, a high-frequency hearing loss thus develops insidiously. Noise, stress or concomitant diseases accelerate the increasing deterioration.

Presbycusis symptoms

As a rule, presbycusis is such a gradual process that it s not even noticed by the affected person himself. The first signs are that

  • TV sets and radioshave to be turned up louder
  • just in agitated situations not everything is understood
  • anymore.
  • the understanding of women's and children's voices is difficult, since these fall in the high-frequency range 

Presbycusis Diagnosis

To make a diagnosis, otolaryngologists take the patient's medical history, look at the ear canal during an otoscopy and look at the eardrum. Factors such as pre-existing conditions, noise exposure, and hereditary predisposition help make the diagnosis of hearing loss. Otoscopy is used to rule out other causes such as a blocked ear canal, a defective eardrum, or inflammation of the middle ear.

The crucial part of the diagnosis, however, is sound and speech audiometry. Sound audiometry is used to determine the hearing threshold, i.e. the loudness at which a sound is perceived by the patient. If a high-frequency hearing loss is determined here in conjunction with deteriorated speech comprehension the diagnosis is considered confirmed.

Presbycusis Treatment

Presbyacusis cannot be treated with medication or surgery. Instead, otolaryngologists issue a prescription for a hearing aid. From here on, the hearing care professional provides hearing aids. These improve the patient's speech comprehension and help him or her participate more actively in life again.


Presbycusis is the diagnosis that most often results in hearing aid fitting. In its progression, age-related hearing loss manifests as a gradual process. Therefore, it is recommended to check one's hearing at regular intervals to detect possible damage at an early stage. The earlier hearing loss is diagnosed, the easier it is to get used to hearing instruments.