How well should you hear at your age? The benchmarks most people don’t know

About one in three Americans between 65 and 74 already has hearing loss, and nearly half of adults over 75 struggle to hear, according to the National Institute on Deafness and Other Communication Disorders. Yet most people have never been told what a normal audiogram is supposed to look like for their decade, or when a slow drift becomes something a clinician should measure.

The reference point is straightforward. Audiologists rate hearing in decibels hearing level (dB HL), which describes the softest sound your ear can reliably detect. Under the classification used by the American Speech-Language-Hearing Association, normal adult hearing sits at 15 dB HL or better, with anything from 16 to 25 dB HL considered slight loss and 26 to 40 dB HL considered mild.

What the severity ranges actually mean

ASHA notes that professionals do not fully agree on where normal ends. Its own chart draws the line at 15 dB HL, but some clinicians use 20 or 25 dB HL as the cutoff before they call a result abnormal.

Where you sit by decade

NIDCD tracks hearing loss severe enough to interfere with everyday communication, and the rate climbs sharply with age.

Also read: What that ringing in your ears may be quietly telling you about your hearing

Those numbers come from the institute's national hearing statistics, which also estimate that around 28.8 million U.S. adults could benefit from hearing aids. Fewer than 1 in 3 adults age 70 and older who could use one has ever tried a device.

Why it feels muffled before it feels quiet

Age-related hearing loss, called presbycusis, does not usually blunt the whole sound spectrum at once. It attacks the top of the range first, which is why speech starts to sound muffled long before it sounds soft. High-frequency loss makes voiceless consonants like p, k, f, s and ch harder to pick out, blurring the edges of words even when the volume feels fine. A 2023 review in Frontiers in Neuroscience describes the pattern as a progressive sensorineural loss that begins in the high frequencies and spreads downward with age.

The mechanism sits in the inner ear. NIDCD points to gradual changes in the cochlea's sensory hair cells, the stria vascularis and the nerve pathways carrying sound to the brain. Long-term noise exposure, high blood pressure, diabetes, family history and certain medications, including some chemotherapy drugs, can accelerate the process.

Signs worth taking to an audiologist

The everyday tells are consistent. Trouble following conversations in a busy restaurant. Asking family members to repeat themselves. Turning the television up until others complain. A sense that people are mumbling, especially women and children whose voices sit higher in the range. NIDCD notes that untreated hearing loss can make it harder to understand a doctor's advice, respond to smoke alarms and stay engaged in social settings.

There is also a cognitive stake. A research letter published in JAMA in January 2023 by Johns Hopkins investigators followed 2,413 older adults and found that dementia prevalence was 61% higher in those with moderate to severe hearing loss than in peers with normal hearing. Hearing aid users had a 32% lower prevalence of dementia than non-users with similar loss.

A pure-tone audiogram, the standard test, takes about 20 to 30 minutes in a soundproof booth and produces a graph of your thresholds across frequencies. Anyone noticing the signs above, or crossing a decade where prevalence jumps, can ask a primary care doctor for a referral to an audiologist. Adults 70 and older who suspect a problem can also buy over-the-counter hearing aids without a prescription under the FDA rule that took effect in 2022.

This article is made and published by Jesper Bengtson, who may have used AI in the preparation.