[Hearing in old age. Hearing loss is never physiologic]

The common form of hardness of hearing seen in old age is not, in the first instance, due to physiological age-related changes as is, for example, presbyopia, but rather to a complex sensorineural pattern of injury. The underlying causes are not yet fully understood. Typical medical risk factors such as hypertension, diabetes mellitus, etc. apparently play a smaller role than increasing environmental noise and modern life styles. The various forms of presbyacusis and their presentation in the pure tone audiogram are discussed.