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Aging is hard on ears. Everything from loud concerts and sports stadium crowds to chemicals in cigarette smoke and cleaning agents can kill the thousands of tiny hair cells in your inner ear, which are responsible for transforming sound waves into nerve signals that the brain interprets as speech or music or an alarm clock.
"When you lose enough hair cells, it begins to affect your hearing,” says Sujana Chandrasekhar, M.D., a partner at ENT and Allergy Associates in New York and New Jersey. “For men, hearing loss often starts in the mid-50s. Women, whose hearing may get some protection from female hormones, are usually affected by their early to mid-60s."
About half of people 75 and older have lost 35 decibels or more of hearing — the point at which a hearing aid is needed. But it can be tough to tell when someone’s hearing is starting to go, even (or especially) if that someone is you. Here are 10 key signs that it may be time to have your hearing evaluated.
- . The first part of hearing to fade with age is the ability to discern high-frequency sounds. In speech, those are consonant sounds and digraphs, like “ch” and “sh". “When you can hear vowels but not consonants, it sounds like people aren’t speaking clearly, so it’s easy to blame them,” says Chandrasekhar.
For example: If someone says, “The elephant has a long trunk that can be used to grab trees,” a person with hearing loss might hear something more like this: “__e ele__a__ _a_ a long _run_ tha_ _an be us__ _o grab _ree_". No wonder it sounds like people are mumbling!
- . Even without consonants we pick up lots of cues about speech from the context, facial expressions and lip reading. But you’ll start making errors. Chandrasekhar says, “With everyone wearing masks this year, it’s become even harder for people who are starting to lose their hearing to bluff their way through conversations."
- “Usually, sound is going in both ears, but when you’re talking on the phone it’s only going in one, which makes it more difficult — especially if you hold the phone to the ear that has more hearing loss,” says Alison Grimes, director of audiology at UCLA Health in Los Angeles. On top of that, phones don’t perfectly transmit speech sounds, which compounds hearing issues, she says.
- Feel like you’re easily startled by loud noises? Blame it on a phenomenon called “recruitment,” which is common in people with hearing loss, says Grimes. It happens because you don’t lose all the hair cells in your ear at the same time. When a sound is on the louder side it triggers the healthy cells to respond more forcefully than they typically would — so louder sounds can be more jarring, or even sound distorted.
- Background noise is difficult for everyone, even those with typical hearing, says Angela Shoup, a professor in the Department of Otolaryngology and chief of the Division of Communicative and Vestibular Disorders at the University of Texas Southwestern Medical Center in Dallas. “One skill we use to ignore background noise is to screen out a certain type of noise, like traffic, which is low-pitched,” she explains. But at a party or restaurant, the competing sounds are human voices nearby — and ignoring other voices to focus on one is more difficult when you’re losing your hearing.
- You might not even realize you have been clicking up the volume button until someone points it out. But if the sound is so loud you need to turn it down to hear someone saying, “Turn down the TV,” it’s a sign something could be wrong with your hearing.
- The inner ear, where hearing occurs, is like a house with two rooms. Your hearing mechanism, or cochlea, is in one room, and your balance mechanism, the semicircular canals, is in the other — and they’re connected by fluid-filled space. So, one affects the other. Plus, we use auditory cues to know where we are in space, says Chandrasekhar: “When you put hearing aids on people with hearing loss, their sense of balance and ability to sense where they are in space improves immensely.”
- “It’s difficult to remember things you don’t hear clearly,” says Shoup. And when you’re struggling to understand what someone is saying, it taxes your short-term memory. Just think about the sentence above about the elephant’s trunk. “Our minds clump information together to make it easier to remember,” Shoup explains. “But people with hearing loss miss lots of sounds, so they have to hold all these random bits and pieces in their short-term memory until they can fill in the blanks to make sense of a sentence.” Sometimes it works, and sometimes it doesn’t.
- . “The punchline is often told in a funny way or it’s a play on words, and if you can’t decipher all the words, you don’t get the joke,” says Chandrasekhar.
- . “It takes a significant amount of energy and concentration to decode a message that is missing numerous elements, which is what speech sounds like to someone with hearing difficulties,” says Shoup, “so it’s harder to focus and sustain attention during a conversation.
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