Progressive hearing loss

If you’re wondering how your hearing loss may progress, the answer will depend on the cause of your problem. If you wear hearing aids, they can’t fix or even slow physical damage to your ears. However, they can slow your loss of comprehension, which has to do with brain processing.

In practical terms, you will experience less trouble with your hearing over time if you consistently wear properly-fitted hearing aids. On the other hand, if you need hearing aids and don’t use them, your comprehension of speech is likely to decline.

What kinds of hearing loss get worse over time?

Sensorineural hearing loss and aging

With sensorineural hearing loss, your inner ear, auditory nerve, or both are damaged, usually permanently. Age-related hearing loss, or presbycusis, fits in this group. It does tend to get worse over time.

Noise gets a share of the blame. “Much of the hearing loss called presbycusis is likely primarily noise-induced,” says retired audiologist Jan Mayes. Research indictates that residents of communities with little noise in their environment “show normal hearing thresholds into their older years,” she adds.

You don’t have to work on a construction site for noise to damage your hearing. About a quarter of American adults age 20 to 69 have noise-induced hearing loss, and more than half of them didn’t suffer this damage on the job. The noise might have come from playing music too loudly through earphones, on public transit, while attending concerts or sports events, or while running power tools and landscape maintenance equipment.

The more loud noises you hear, the more damage, so this kind of loss builds up over time. 

Sudden hearing loss

If you experience a sudden hearing loss—all at once or within three days—seek medical care immediately. This kind of change typically occurs in only one ear. Often the exact cause is never established. Although sudden hearing loss it is usually sensorineural, in about half of all cases, you can recover all or some of your hearing within two weeks. But don’t delay treatment—that window closes within a month. 

Conductive hearing loss is generally not progressive, as it is a type of hearing loss that usually can be corrected with medical treatment or surgery. It occurs when sound waves cannot reach the inner ear because of earwax, fluid, anatomical problems, or a punctured eardrum.

Why do older people tend to have worse hearing? 

The main reasons are aging and noise exposure, which usually affects both ears equally. Because it comes on gradually, getting worse over time, your family and friends may notice it sooner than you do.

Presbycusis tends to run in families.

In addition, problems more common in older people—diabetes, high blood pressure, a heart condition or stroke—may affect hearing.

Medications can damage the inner ear, sometimes permanently. They may be needed to treat diseases more common in older people, including cancer and heart disease. 

Some forms of inherited hearing loss can show up in middle age. One example is otosclerosis, when bones grow abnormally within the middle ear.  

Finally, noise-induced damage, as noted earlier, builds up over time. If you’re blasting the television to compensate for your hearing loss, you’re endangering the hearing of everyone nearby and possibly your own. The same goes for your power saw and lawn mower.  

If you must use loud equipment, prevent hearing loss by wearing protective headphones or earmuffs that safely amplify the sounds you need to hear while minimizing noise. 

Will hearing aids slow age-related hearing loss (presbycusis)?

The old saying, “Use it or lose it,” applies to your hearing. When hearing loss goes uncorrected, parts of the brain that process sound literally shrink, known as brain atrophy. This can lead to depression and dementia.

That’s one reason it is important to do everything possible to protect your residual hearing. Hearing aids can only amplify sounds; your brain has to process them. 

The bottom line: When it comes to your eyes, you know that glasses can’t correct cataracts or blindness. In the same way, hearing aids work with the hearing you have.

To keep your auditory nerve stimulated, you will need to wear your hearing aids regularly, even when you’re home alone. Happily, it usually can respond to that stimulation. Your hearing may still worsen over time, but regular check-ups with your hearing specialist will ensure your hearing aids are programmed correctly. 

What can I do when my hearing gets really bad? 

If your hearing loss becomes severe or profound, be reassured that there are “power” or “super power” hearing aids available. Other options are a bone-anchored system or a cochlear implant, which can be used in people of all ages, including seniors. 

Help! My hearing loss seems worse since I started to wear my new aids.

Some people worry that a hearing aid could make their hearing worse. That would only happen if it is set to be too loud. This might be a problem with over-the-counter hearing aids you choose without help but not aids programmed by an audiologist.

Sometimes when people begin wearing appropriately-programmed hearing aids, they notice their difficulties hearing more keenly when they take the hearing aids off. In the past, they thought they could function without hearing aids—and now they can’t.

This is actually a good sign. It means your brain has begun processing the sounds you used to miss. So when you can’t hear them, you now notice the difference. Congratulations! You have broadened your perception of the world around you.