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Presbycusis
What's new
Added 2024 AAO-HNSF, 2024 AAFP, 2023 SFORL/SFA, and 2021 USPSTF guidelines for the diagnosis and management of presbycusis .
Background
Overview
Definition
Presbycusis, also known as age-related hearing loss, is a multifactorial process characterized by a gradual, progressive, and symmetrical loss of hearing ability that occurs as part of the natural aging process.
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Pathophysiology
The pathophysiology of presbycusis involves degenerative processes associated with aging, such as the loss of hair cells in the cochlea and the degeneration of auditory nerve fibers. These changes can lead to impairments in both peripheral hearing and central auditory processing, contributing to the overall hearing loss.
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Epidemiology
The prevalence of presbycusis in the US is estimated at 29.3%, 55.1%, and 79.1% at 60-69 years, 70-79 years, and ≥ 80 years, respectively.
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Risk factors
Risk factors for presbycusis include advanced age, prolonged exposure to loud noise, genetic predisposition, ototoxic medications, and certain conditions such as diabetes and CVD.
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Disease course
The clinical course of presbycusis typically begins with difficulty in hearing high-frequency sounds, which gradually progresses to a generalized hearing loss over time. This process is often gradual, so the individual may not notice the hearing loss until it becomes severe.
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Prognosis and risk of recurrence
The hearing loss in presbyscusis is irreversible, with significant impacts on the QoL, including effects on communication, social isolation, depression, and potentially dementia.
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Guidelines
Key sources
The following summarized guidelines for the evaluation and management of presbycusis are prepared by our editorial team based on guidelines from the American Academy of Family Physicians (AAFP 2024,2019), the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF 2024), the French Society of Audiology (SFA/SFGG/SFORL 2023), and the U.S. Preventive Services Task Force (USPSTF 2021).
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