Presbycusis: Diagnosis, Treatment, and Its Association with Dementia

Presbycusis, or age-related hearing loss, is a complex, multidimensional, progressive, and irreversible condition that ranks as a leading cause of disability among older adults. Previously considered merely a consequence of aging, it is now understood as a disorder influenced by a variety of factors, including genetics, exposure to noise, ototoxic substances, and metabolic diseases. This form of hearing loss significantly diminishes the quality of life for older adults, leading to social isolation and greater use of healthcare services. It triggers social withdrawal, an increased dependence on healthcare systems, and a range of comorbidities such as physical frailty, an elevated risk of falls, musculoskeletal injuries, and psychological distress. Notably, recent research highlights presbycusis as a crucial, modifiable risk factor for dementia, underscoring its significant impact on brain health. Despite its widespread prevalence, especially among those over the age of 70, presbycusis continues to be underdiagnosed and undertreated due to patient denial, societal stigma, and the absence of standard screenings by healthcare professionals. This chapter delves into presbycusis, focusing on its prevalence, pathophysiology, clinical presentation, risk and protective factors, diagnostic measures, treatment options, and its link with an increased risk of dementia.