Laryngorhinootologie 2016; 95(07): 497-510
DOI: 10.1055/s-0042-106918
© Georg Thieme Verlag KG Stuttgart · New York

Presbyakusis – Altersschwerhörigkeit

Presbycusis – Age Related Hearing Loss
N. Fischer
1   Klinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck
B. Weber
2   Klinik für Hör-, Stimm- und Sprachstörungen, Medizinische Universität Innsbruck
H. Riechelmann
1   Klinik für Hals-, Nasen- und Ohrenheilkunde, Medizinische Universität Innsbruck
› Author Affiliations
Further Information

Publication History

Publication Date:
08 July 2016 (online)


Bei der Presbyakusis oder Altersschwerhörigkeit handelt es sich um eine langsam progrediente, bilaterale, symmetrische sensorineurale Hörminderung, welche durch Alterungsprozesse im Innenohr entsteht. Die Ätiologie ist multifaktoriell, wobei mehrere Risikofaktoren bekannt sind und auch die Genetik eine große Rolle spielt. Durch histologisch nachweisbare Veränderungen der Innenohrstrukturen kommt es zu einer zunehmenden Hörverschlechterung, welche vor allem den Hochtonbereich betrifft. Das daraus resultierende erschwerte Sprachverstehen hat einen negativen Einfluss auf kognitive, emotionale und soziale Funktionen im Alter, was zu sozialer Isolation, Angst, Depression und kognitivem Verfall führen kann. Daher sind das Erkennen und die richtige Versorgung der Schwerhörigkeit im Alter sehr wichtig. Für viele Schwerhörige ist die Versorgung mit konventionellen Hörgeräten weiterhin die Therapieform der Wahl. Durch den technischen Fortschritt der implantierbaren Hörsysteme können nun auch hochgradige Schwerhörigkeiten im Alter mit gutem Erfolg rehabilitiert werden. Dennoch ist ein Großteil der Schwerhörigen nicht ausreichend versorgt.


Presbycusis or age related hearing loss can be defined as a progressive, bilateral and symmetrical sensorineural hearing loss due to age related degeneration of inner ear structures. It can be considered a multifactorial complex disorder with environmental and genetic factors. The molecular, electrophysiological and histological damage at different levels of the inner ear cause a progressive hearing loss, which usually affects the high frequencies of hearing. The resulting poor speech recognition has a negative impact on cognitive, emotional and social function in older adults. Recent investigations revealed an association between hearing impairment and social isolation, anxiety, depression and cognitive decline in elderly. These findings emphasize the importance of diagnosis and treating hearing loss in the elderly population. Hearing aids are the most commonly used devices for treating presbycusis. The technical progress of implantable hearing devices allows an effective hearing rehabilitation even in elderly with severe hearing loss. However, most people with hearing impairments are not treated adequately.

  • Literatur

  • 1 Roosa DBSJ. Presbykousis. Trans Am Otol Soc 1885; 449-460
  • 2 Pearlman RC. Presbycusis: the need for a clinical definition. Am J Otol 1982; 3: 183-186
  • 3 Gates GA, Mills JH. Presbycusis. Lancet 2005; 366: 1111-1120
  • 4 Arvin B, Prepageran N, Raman R. „High frequency presbycusis“-is there an earlier onset?. Indian J Otolaryngol Head Neck Surg 2013; 65: 480-484
  • 5 WHO. WHO Report of the Informal Working Group On Prevention Of Deafness And HearingImpairment Programme Planning. Geneva: 1991
  • 6 Bundesausschuss G. Richtlinie des Gemeinsamen Bundesausschusses über die Verordnung von Hilfsmitteln in der vertragsärztlichen Versorgung. Berlin: Eigenverlag 2014; 2014: 21
  • 7 Roth TN, Hanebuth D, Probst R. Prevalence of age-related hearing loss in Europe: a review. Eur Arch Otorhinolaryngol 2011; 268: 1101-1107
  • 8 Gablenz P, Holube I. Prevalence of hearing impairment in northwestern Germany. HNO 2015; 63: 195-214
  • 9 WHO. Deafness and hearing impairment survey – report of the consultative meeting of principal investigators SEARO, New Delhi, 7-9 May 2001. New Delhi: 2001
  • 10 Hjalte F, Brannstrom J, Gerdtham UG. Societal costs of hearing disorders: a systematic and critical review of literature. Int J Audiol 2012; 51: 655-662
  • 11 Stucky SR, Wolf KE, Kuo T. The economic effect of age-related hearing loss: national, state, and local estimates, 2002 and 2030. J Am Geriatr Soc 2010; 58: 618-619
  • 12 Shield B. Evaluation of the Social and Economic Costs of Hearing Impairment. In : ed:; 2006
  • 13 Ciorba A, Hatzopoulos S, Bianchini C. Genetics of presbycusis and presbystasis. International journal of immunopathology and pharmacology 2015; 28: 29-35
  • 14 Ruan Q, Ma C, Zhang R. Current status of auditory aging and anti-aging research. Geriatr Gerontol Int 2014; 14: 40-53
  • 15 Hendrickx JJ, Huyghe JR, Topsakal V. Familial aggregation of pure tone hearing thresholds in an aging European population. Otol Neurotol 2013; 34: 838-844
  • 16 Gates GA, Couropmitree NN, Myers RH. Genetic associations in age-related hearing thresholds. Arch Otolaryngol Head Neck Surg 1999; 125: 654-659
  • 17 Noben-Trauth K, Zheng QY, Johnson KR. Association of cadherin 23 with polygenic inheritance and genetic modification of sensorineural hearing loss. Nat Genet 2003; 35: 21-23
  • 18 Bottger EC, Schacht J. The mitochondrion: a perpetrator of acquired hearing loss. Hear Res 2013; 303: 12-19
  • 19 Fransen E, Topsakal V, Hendrickx JJ. Occupational noise, smoking, and a high body mass index are risk factors for age-related hearing impairment and moderate alcohol consumption is protective: a European population-based multicenter study. J Assoc Res Otolaryngol 2008; 9: 264-276 discussion 261–263
  • 20 Momi SK, Wolber LE, Fabiane SM. Genetic and Environmental Factors in Age-Related Hearing Impairment. Twin Res Hum Genet 2015; 18: 383-392
  • 21 Oh IH, Lee JH, Park DC. Hearing loss as a function of aging and diabetes mellitus: a cross sectional study. PLoS One 2014; 9: e116161
  • 22 Pawelec G, Goldeck D, Derhovanessian E. Inflammation, ageing and chronic disease. Curr Opin Immunol 2014; 29: 23-28
  • 23 Verschuur C, Agyemang-Prempeh A, Newman TA. Inflammation is associated with a worsening of presbycusis: evidence from the MRC national study of hearing. Int J Audiol 2014; 53: 469-475
  • 24 Kurata N, Schachern PA, Paparella MM. Histopathologic Evaluation of Vascular Findings in the Cochlea in Patients With Presbycusis. JAMA Otolaryngol Head Neck Surg 2016; 142: 173-178
  • 25 Schuknecht HF, Gacek MR. Cochlear pathology in presbycusis. Ann Otol Rhinol Laryngol 1993; 102: 1-16
  • 26 Lee KY. Pathophysiology of age-related hearing loss (peripheral and central). Korean journal of audiology 2013; 17: 45-49
  • 27 Spoendlin H. The innervation of the cochlea receptor. Moller, AR Mechanisms in Hearing 1973; 185-229
  • 28 Spoendlin H, Schrott A. The spiral ganglion and the innervation of the human organ of Corti. Acta Otolaryngol 1988; 105: 403-410
  • 29 Bowl MR, Dawson SJ. The mouse as a model for age-related hearing loss – a mini-review. Gerontology 2015; 61: 149-157
  • 30 Yang CH, Schrepfer T, Schacht J. Age-related hearing impairment and the triad of acquired hearing loss. Front Cell Neurosci 2015; 9: 276
  • 31 Ouda L, Profant O, Syka J. Age-related changes in the central auditory system. Cell and tissue research 2015; 361: 337-358
  • 32 Profant O, Balogova Z, Dezortova M. Metabolic changes in the auditory cortex in presbycusis demonstrated by MR spectroscopy. Experimental gerontology 2013; 48: 795-800
  • 33 Hesse G. Innenohrschwerhörigkeit. 1. Aufl. Aufl Stuttgart [u. a.]: Thieme; 2015
  • 34 Gates GA. Central presbycusis: an emerging view. Otolaryngol Head Neck Surg 2012; 147: 1-2
  • 35 Liu M, Alafris A, Longo AJ. Irreversible atorvastatin-associated hearing loss. Pharmacotherapy 2012; 32: e27-e34
  • 36 Reiß M. Facharztwissen HNO-Heilkunde. In: Reiß M. (ed.). [Online-Ausg.] (ed.) Berlin, Heidelberg: Imprint: Springer; 2009
  • 37 Gordon-Salant S. Hearing loss and aging: new research findings and clinical implications. J Rehabil Res Dev 2005; 42: 9-24
  • 38 Frisina DR, Frisina RD. Speech recognition in noise and presbycusis: relations to possible neural mechanisms. Hear Res 1997; 106: 95-104
  • 39 Böhme G, Welzl-Müller K. Audiometrie: Hörprüfungen im Erwachsenen- und Kindesalter; ein Lehrbuch. 5., überarb. und erg. Aufl. Aufl. Bern [u. a.]: Huber; 2005
  • 40 Nikolas H, Blevins M. Presbycusis. In: Daniel G, Deschler M. Lee, Park, (Hrsg.) UpToDate; 2015
  • 41 Ives DG, Bonino P, Traven ND. Characteristics and comorbidities of rural older adults with hearing impairment. J Am Geriatr Soc 1995; 43: 803-806
  • 42 Uhlmann RF, Larson EB, Rees TS. Relationship of hearing impairment to dementia and cognitive dysfunction in older adults. JAMA 1989; 261: 1916-1919
  • 43 Lindenberger U, Baltes PB. Sensory functioning and intelligence in old age: a strong connection. Psychol Aging 1994; 9: 339-355
  • 44 Lin FR, Yaffe K, Xia J. Hearing loss and cognitive decline in older adults. JAMA Intern Med 2013; 173: 293-299
  • 45 Mick P, Kawachi I, Lin FR. The association between hearing loss and social isolation in older adults. Otolaryngol Head Neck Surg 2014; 150: 378-384
  • 46 Berg AI, Johansson B. Personality Change in the Oldest-Old: Is It a Matter of Compromised Health and Functioning?. J Pers 2013; DOI: 10.1111/jopy.12030.
  • 47 Cacciatore F, Napoli C, Abete P. Quality of life determinants and hearing function in an elderly population: Osservatorio Geriatrico Campano Study Group. Gerontology 1999; 45: 323-328
  • 48 Capella-McDonnall ME. The effects of single and dual sensory loss on symptoms of depression in the elderly. Int J Geriatr Psychiatry 2005; 20: 855-861
  • 49 McDonnall MC. The effects of developing a dual sensory loss on depression in older adults: a longitudinal study. J Aging Health 2009; 21: 1179-1199
  • 50 Bernabei V, Morini V, Moretti F. Vision and hearing impairments are associated with depressive – anxiety syndrome in Italian elderly. Aging Ment Health 2011; 15: 467-474
  • 51 Li CM, Zhang X, Hoffman HJ. Hearing impairment associated with depression in US adults, National Health and Nutrition Examination Survey 2005-2010. JAMA Otolaryngol Head Neck Surg 2014; 140: 293-302
  • 52 Malini FM, Lourenco RA, Lopes CS. Prevalence of fear of falling in older adults, and its associations with clinical, functional and psychosocial factors: The Frailty in Brazilian Older People-Rio de Janeiro Study. Geriatr Gerontol Int 2015; DOI: 10.1111/ggi.12477.
  • 53 Chou R, Dana T, Bougatsos C. Screening adults aged 50 years or older for hearing loss: a review of the evidence for the U.S. preventive services task force. Annals of internal medicine 2011; 154: 347-355
  • 54 Pirozzo S, Papinczak T, Glasziou P. Whispered voice test for screening for hearing impairment in adults and children: systematic review. Bmj 2003; 327: 967
  • 55 Parham K, Lin FR, Coelho DH. Comprehensive management of presbycusis: central and peripheral. Otolaryngol Head Neck Surg 2013; 148: 537-539
  • 56 Hong JY, Oh IH, Jung TS. Clinical reasons for returning hearing aids. Korean journal of audiology 2014; 18: 8-12
  • 57 Zenner hvH-P. Praktische Therapie von HNO-Krankheiten. 2., vollst. überarb. und erw. Aufl. Aufl Stuttgart [u. a.]: Schattauer; 2008
  • 58 Wolf-Magele A, Schnabl J, Woellner T. Active middle ear implantation in elderly people: a retrospective study. Otol Neurotol 2011; 32: 805-811
  • 59 Noble W, Tyler RS, Dunn CC. Younger- and older-age adults with unilateral and bilateral cochlear implants: speech and spatial hearing self-ratings and performance. Otol Neurotol 2009; 30: 921-929
  • 60 Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkund K-uH-CeV. S2k-Leitlinie: Cochlea-Implantat Versorgung einschließlich zentral-auditorischer Implantate. In : Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften; 2012
  • 61 Rafferty A, Tapper L, Strachan D. Cochlear implantation in older patients: outcomes and comparisons. Rev Laryngol Otol Rhinol (Bord) 2013; 134: 119-124
  • 62 Fu QJ, Galvin 3rd JJ. Maximizing cochlear implant patients' performance with advanced speech training procedures. Hear Res 2008; 242: 198-208
  • 63 Mosnier I, Bebear JP, Marx M. Improvement of cognitive function after cochlear implantation in elderly patients. JAMA Otolaryngol Head Neck Surg 2015; 141: 442-450