Presbycusis other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Farman Khan, MD, MRCP [2]

Other Diagnostic Studies

Due to the high prevalence of presbycusis in people of retirement age and the adverse effects of hearing loss on well-being, screening for hearing loss should be done at an annual physical examinations or at the first visit for new patients over the age of 60. A single question on an intake form “do you have a hearing problem?” is a very cost effective and sensitive instrument to screen for presbycusis.[1]

The 10-item hearing handicap inventory for the elderly-short form (HHIE-S) is widely used for screening. However, the HHIE-S under-reports hearing loss because its sensitivity is lower than the single question “do you have a hearing problem?”[1] The value of screening is justified by the effectiveness of remediation. [2] The standard screening audiometer tests at 1 kHz, 2 kHz, and 3 kHz at intensity levels of 25 dB, 40 dB, and 60 dB. Failure at any one frequency at 25 dB for younger adults or 40 dB for retired individuals justifies a referral for definitive assessment. A metabolic assessment might be indicated if the patient has not had a recent health examination. Diabetes, renal dysfunction, hypertension, and hyperlipidemia should be excluded as co-factors.[3] In a patient with presbycusis, an audiogram will show downward-sloping pure tone thresholds with relative preservation of word recognition scores. Imaging studies, like CT scans and MRI, are not indicated for the diagnosis of presbycusis. An MRI may be done to rule out neural or central pathology in cases with asymmetric hearing loss, or if there is an indication of possible tumors, such as vestibular schwannoma or other skull base lesions .


  1. 1.0 1.1 Gates GA, Murphy M, Rees TS, Fraher A (2003). "Screening for handicapping hearing loss in the elderly". The Journal of Family Practice. 52 (1): 56–62. PMID 12540314. Unknown parameter |month= ignored (help)
  2. Hands S (2000). "Hearing loss in over-65s: is routine questionnaire screening worthwhile?". The Journal of Laryngology and Otology. 114 (9): 661–6. PMID 11091826. Unknown parameter |month= ignored (help)
  3. Gates GA, Mills JH (2005). "Presbycusis". Lancet. 366 (9491): 1111–20. doi:10.1016/S0140-6736(05)67423-5. PMID 16182900.