Aging may have its benefits, but apparently crystal-clear hearing is not one of them.

Nearly two-thirds of adults over the age of 70 in the United States experience hearing loss. Erika Walsh, M.D., director of the Division of Otology and Neurotology at the University of Alabama at Birmingham Marnix E. Heersink School of Medicine, says hearing loss in adults is usually multi-factorial.

“Important contributors to hearing loss are lifetime cumulative noise exposure, genetic predisposition, prior history of chronic ear infections, exposure to certain medications and agents associated with hearing loss, exposure to toxins — alcohol and tobacco, and changes in the cochlea with time,” Walsh said.

Signs of hearing loss can be subtle. Patients should look for more difficulty communicating, especially in challenging situations like in background noise. They may also notice the volume on the television or radio creeping up.

Some patients with hearing loss may initially be more aware of symptoms that are associated with hearing loss, such as tinnitus or head noise and a sensation of fullness and congestion in the ears. Caregivers and families may notice that a patient may seem less engaged, more socially withdrawn, or may seem to misunderstand or be unaware of prior conversations.

“If a patient’s hearing loss is so severe they cannot communicate with a telephone, that can be a sign that more advanced hearing loss technology, such as a cochlear implant, may be appropriate,” Walsh said.

Walsh says undertreated hearing loss has major public health implications.

“Hearing loss is independently associated with increased risk of falls, cognitive decline, depression and social isolation, and poor health-related outcomes, including management of other chronic diseases, like diabetes,” Walsh said.

A silent disability

Walsh says that addressing the issue of hearing loss with parents or loved ones may be difficult, but it is not something to sweep under the rug.

“I believe talking about hearing loss isn’t something to avoid,” she said. “For many of my patients, their hearing loss is a silent disability, because others cannot easily see they are hard of hearing. So, talk about communication concerns early and often.”

Walsh says some patients and families see hearing loss as affecting only elderly or infirm patients, and that could not be further from the truth. Patients of all ages can suffer from hearing loss, and by treating their hearing loss, patients are better able to engage professionally and socially.

Searching for a solution

There are many options available to patients with hearing loss depending on the patient’s type and severity of hearing loss. Hearing aids are the most important non-surgical option.

“Some patients cringe when they hear me say, ‘You would benefit from a hearing aid’; but hearing aids have come a long way,” Walsh said. “They can be visually discreet and have really cool and useful features, including Bluetooth streaming to their digital devices. Once my patients try them, many don’t know how they functioned without them.”

Surgical options for hearing loss include implantable hearing devices, including middle ear implants and prostheses, bone-anchored hearing devices, and cochlear implants. A licensed audiologist and otolaryngologist can help guide patients in both surgical and non-surgical options for hearing loss.

To help prevent hearing loss, Walsh recommends regular hearing screenings, wearing protective ear gear when exposed to loud noises, and avoiding harmful substances such as tobacco and excessive alcohol. In addition, older adults should also seek prompt treatment for any hearing problems, such as infections or injury, to prevent further damage.

Article originally appeared on UABNews