Your ears — like the rest of you — change with age. And it’s not only your hearing that’s affected: Everything from the texture of earwax to your risk of having tinnitus changes in midlife and beyond. But experts say the following good habits can help keep your ears healthy for years to come.
1. Get regular screenings
Think of regular hearing screenings like routine dental or eye exams: Your medical provider will make sure everything is functioning as it should and look for any problems — like hearing loss — in a timely manner.
“Screening does not necessarily mean a hearing test,” says audiologist Lindsay Creed, associate director of audiology practices for the American Speech-Language-Hearing Association (ASHA). “It can be a two-stage process, the first stage being a questionnaire or your medical doctor asking you three or four questions in conjunction with your physical.”
According to guidelines from the World Health Organization, adults 50 and older without hearing loss should be screened every five years through age 64, Creed says. Starting at 65, the guidelines recommend screening every one to three years (hearing loss and other conditions may call for more frequent monitoring).
2. Maintain your hearing aids
Hearing aid users should have their devices checked by a hearing specialist at least once a year. Daily maintenance is also important. “Hearing aids are essentially miniature electronics. Keep them protected from the elements such as rain and dust and keep them out of reach from prying hands of children or prying paws of dogs,” says audiologist Viral Tejani, assistant professor of otolaryngology-head and neck surgery at Case Western Reserve University School of Medicine.
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Hearing aid life span is another factor to consider. According to Tejani, audiologists typically recommend replacing the devices every five to seven years, both because manufacturers may phase out support for older hearing aids and because new technology may offer advanced features. “That being said, there are patients who care for their devices so well that sometimes they don’t replace them after 10 years or so,” he says. “That is fine, as long as they are benefiting from their devices.”
3. Know the signs of tinnitus, vertigo
Along with age-related hearing loss, which affects an estimated 1 in 3 adults 65 and older, other ear-related conditions also become more common with age. These include tinnitus, which peaks in prevalence among adults ages 60 to 69 and causes ringing (or sounds like hissing, whooshing or buzzing) in the ears.
According to the American Tinnitus Association, the “vast majority” of tinnitus cases are caused by sensorineural hearing loss — that’s the kind responsible for age-related hearing loss, or presbycusis. While no cure for tinnitus currently exists, treatment options can help lessen its severity.
Another risk for older adults: benign paroxysmal positional vertigo, or BPPV, which results in episodes of dizziness and is caused by the displacement of tiny calcium crystals found within the inner ear. “Under the age of 50 … the most common cause of displacement is head trauma,” Creed says. “Over 50, the most common cause is age-related changes to the utricle, or the organ where those tiny crystals live.”
Once you’ve had BPPV, Creed says a repeat episode becomes more likely. Fortunately, the condition can typically be treated with a series of head movements that reposition the crystals. Your audiologist or medical provider can perform this maneuver as a simple in-office procedure (don’t try it at home without first receiving a professional diagnosis and guidance, Creed warns).
4. Be aware of comorbidities and medications
Chronic conditions including sleep apnea, diabetes, high blood pressure, high cholesterol and cardiovascular disease up your risk of hearing loss. If you’re at increased risk, your provider may recommend more frequent screenings to monitor your hearing, Creed says.
Some medications are ototoxic, meaning they can damage the ear and result in permanent or temporary hearing loss, tinnitus or balance disorders. These include certain cancer chemotherapy drugs, antibiotics and loop diuretics. If you’re taking an ototoxic medication, discuss the potential for hearing damage with your doctor. A baseline hearing and balance test before you start treatment, as well as periodic hearing tests during treatment, are recommended by ASHA.
5. Mind your earwax
If you’ve noticed changes to your earwax with age, you’re not imagining things. The waxy, protective substance that coats the ear canal actually gets drier and harder as we get older, which can lead to problems with excess buildup or blockages that result in symptoms like hearing loss, ringing in the ear or a sensation of fullness.
If you suspect you have excess or impacted earwax, your general practitioner (or, in more severe cases, an otolaryngologist) can use a few different methods to safely clear out your canals. Buildup or not, Creed cautions that cotton swabs and other implements like bobby pins should never be inserted into the ear — doing so can cause damage and push wax farther into the canals. As a general rule, “nothing smaller than your elbow should go in your ear,” she says.
6. Wear ear protection
Whether or not you have hearing loss, experts say that protecting your ears during noisy activities — think concerts, sporting events or even mowing the lawn — is always a good idea. According to the Centers for Disease Control and Prevention, as many as 30 to 50 percent of hair cells in the inner ear responsible for hearing may be permanently damaged or destroyed before hearing loss becomes evident on a hearing test. That means the best time to get in the habit of using ear protection is before you notice hearing loss in the first place. Tejani recommends disposable foam earplugs as an inexpensive, accessible way to safeguard your hearing (he wears them himself on flights). “It’s never too soon to protect your hearing,” he says.
Sarah Elizabeth Adler joined aarp.org as a writer in 2018. Her pieces on science, art and culture have appeared in The Atlantic, where she was previously an editorial fellow, California magazine and elsewhere.