The most common type of hearing loss — gradual, usually bilateral, and often invisible until it's affecting relationships.
Presbycusis (age-related hearing loss) typically begins in your 50s and progresses slowly. It affects high frequencies first, which is why speech clarity (especially consonants like S, F, and TH) fades before overall volume does. Many people report that they "hear fine — people just mumble."
Most age-related loss is treatable with hearing aids, and earlier treatment correlates with better outcomes. Untreated loss is now a leading modifiable risk factor for cognitive decline (Lancet Commission on Dementia, 2020, 2024).
Permanent damage from loud sound — concerts, construction, firearms, subway noise, personal audio. Preventable; not reversible.
Your ears contain about 15,000 hair cells that convert sound into neural signals. Once damaged by overexposure to loud sound, they do not regenerate. The classic warning sign of damage: temporary muffling or ringing after a loud event.
Custom hearing protection — musician plugs, shooter's plugs, industrial protection — preserves the full sound spectrum while reducing overall level. A much better experience than foam plugs, and dramatically more effective.
Ringing, buzzing, or humming with no external source. Not a disease; a symptom — and one with effective management strategies.
Tinnitus is experienced by roughly 50 million Americans. For some it's a minor background hum; for others, it makes quiet unbearable. It's almost always paired with some degree of hearing loss, which is why a complete audiometric evaluation is the first step of any tinnitus workup.
Effective tools include hearing aids with sound therapy programs, dedicated sound generators, cognitive-behavioral approaches, and tinnitus retraining therapy. See our Tinnitus Management page for details.
Growing research links untreated hearing loss to cognitive decline. Treatment may slow that risk — one of the most actionable levers in healthy aging.
The 2024 Lancet Commission on Dementia identified hearing loss as the largest modifiable risk factor for dementia, linked to roughly 7% of attributable risk. The ACHIEVE clinical trial (Johns Hopkins, 2023) showed a 48% reduction in cognitive decline over three years among high-risk older adults treated with hearing aids.
The mechanism is plausible and multi-factorial: cognitive load from effortful listening, social disengagement, reduced neural stimulation, and potentially shared underlying vascular factors. Whatever the cause, treating hearing loss well is good brain care.