Hearing Loss Can Be Prevented - How Age-Related Hearing Loss Works and the Habits That Protect Your Ears

Are You Missing the Signs of Hearing Loss?

You catch yourself saying "sorry?" more often. Your family tells you the television is too loud. Conversation in a noisy place is hard to follow. These are the early signs of age-related hearing loss, also known as presbycusis. Many people first become aware of a decline in their 50s, but in reality hearing in the high-frequency range is already declining gradually from the 30s.

According to an estimate published by the WHO in 2021, some 1.5 billion people worldwide live with some degree of hearing loss, and the figure is projected to reach 2.5 billion by 2050. In Japan, roughly one in three people aged 65 and over is said to have hearing loss at a level that interferes with daily life.

How Age-Related Hearing Loss Works

Sound enters through the outer ear, sets the eardrum vibrating, passes through the tiny bones of the middle ear, and reaches the cochlea in the inner ear. Inside the cochlea are sensors called hair cells, which convert the vibrations of sound into electrical signals and send them to the brain.

The main cause of age-related hearing loss is damage to these hair cells and the resulting loss of them. Once a hair cell is destroyed, it does not regenerate. Reduced blood flow with age, accumulated oxidative stress, and genetic factors act in combination, and hair cells are gradually lost. The reason high frequencies are the first to become hard to hear is that the hair cells responsible for high tones sit near the entrance of the cochlea, where they are most exposed to the energy of sound.

Noise Exposure - The Biggest Preventable Risk

Among the risk factors for age-related hearing loss, the one where prevention pays off most is limiting noise exposure. Prolonged exposure to sound of 85 dB or more leaves irreversible damage accumulating in the hair cells. To put 85 dB in context, that is roughly the volume of a busy road or a noisy restaurant.

Earphones and headphones are a particular problem. The recommended approach is the "60-60 rule": keep the volume at or below 60% of maximum, and keep continuous use to within 60 minutes. Because noise-cancelling earphones block out the noise around you, you do not need to turn the volume up.

Everyday Habits That Protect Your Ears

The habits that preserve hearing overlap a great deal with looking after your health as a whole. Aerobic exercise improves blood flow in the inner ear and maintains the oxygen supply to the hair cells. Giving up smoking prevents damage to the tiny blood vessels of the inner ear. Managing your blood pressure and blood sugar prevents vascular damage inside the ear.

On the dietary side, foods containing antioxidants (vitamin C, vitamin E, and magnesium) have been shown to help protect hearing. There are also research findings that folate intake lowers the risk of age-related hearing loss. In the end, efforts to prevent lifestyle diseases translate directly into protecting your hearing.

The Risks of Leaving Hearing Loss Alone

Dismissing hearing loss as "just my age" and leaving it alone carries serious risks. A decline in hearing brings difficulty in communication and accelerates social isolation. When exchanges you cannot make out keep piling up, you start to avoid conversation altogether, and the opportunities to talk with people dwindle. Picking words apart, assembling their meaning, and working out a reply is a powerful stimulus for the brain. Losing those opportunities is thought to work against the maintenance of cognitive function.

The 2020 report of the Lancet Commission on dementia prevention also lists hearing loss in midlife as one of the risk factors that can be addressed in the course of daily life. Detecting hearing loss early and responding appropriately, for instance by using a hearing aid, is an important health behavior that also supports the maintenance of cognitive function.

Getting Past Resistance to Hearing Aids

That hearing aid use in Japan is low compared with Europe and North America has been pointed out repeatedly in ear, nose and throat clinics. Even among people who are aware they are not hearing well, plenty spend years without ever trying one. The main cause is psychological resistance: "I am not at that point yet," or "it would be embarrassing."

Today's hearing aids, however, have become steadily smaller and more capable, and many are barely noticeable to look at. Starting to use one early makes it easier for the brain to adapt to processing sound, and the benefit is correspondingly greater. If you only start once hearing loss has progressed, the brain takes longer to readjust to sound. Understanding the causes of tinnitus and how to cope with it is also an important part of looking after your hearing health.

Why Regular Hearing Tests Matter

Because a decline in hearing progresses extremely slowly, it has the characteristic of being hard for the person concerned to notice. If your annual health check does not include a hearing test, having your hearing checked periodically at an ear, nose and throat clinic is recommended.

People aged 40 and over, those who work in noisy environments, and those in the habit of using earphones for long stretches should in particular make a hearing test once a year part of their routine. Early detection and early action is the best strategy for protecting both your hearing and your quality of life. Just as with worries about the visible changes that come with age, facing changes in your hearing sooner widens the range of options open to you.