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Andrey Popov/iStockphoto

Age-related hearing loss typically begins in our mid-40s and 50s. We may not admit it, even to ourselves, but perceiving others as mumbling – especially in noisy situations – is a dead giveaway.

People who develop hearing problems should get help early on, said Kathy Pichora-Fuller, a former audiologist who studies the links between age-related hearing decline and cognition at the Toronto Rehabilitation Institute and Rotman Research Institute at Baycrest Health Sciences.

Left unchecked, hearing loss may lead to withdrawal from socializing and other activities that keep people active, mentally and physically – and help us age well. The good news is that older adults can learn to cope with hearing problems using certain cognitive skills that tend to improve rather than decrease with age, Pichora-Fuller said.

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Here are three things to know about age-related hearing loss.

Three types of hearing loss get worse with age

Damage to the hair cells of the inner ear is usually a consequence of listening to music at full blast or using machinery without ear protection. It can start when we're young and worsen with age.

Changes in blood flow to the inner ear can alter its chemistry in ways that reduce hearing. This type is more common in older adults.

The third type involves damage to nerves that connect the ears to the brain, which can disrupt how auditory information is delivered to the brain.

Auditory-nerve damage may result from lifelong exposure to noise, even if the noise is not loud enough to permanently change one's ability to pick up sounds at low volumes, Pichora-Fuller explained.

A hearing test will not detect all types of hearing loss

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The standard test, called an audiogram, measures the quietest sounds you can hear at different pitches over a range of about five octaves. The first two types of hearing loss will show up on an audiogram.

But someone with damage to the auditory nerves may have normal results on an audiogram and still have trouble hearing in everyday life.

Hearing aids are not the only answer

If sounds are loud enough but the person still has trouble hearing clearly and understanding speech, other solutions may be helpful, Pichora-Fuller said.

Even if hearing becomes more difficult over time, older adults can learn to watch people's faces, gestures and other visual cues to make it easier to understand what they are saying. They can use headphones to reduce background noise while watching television.

Outside the home, hearing assistive devices can help people zero in on salient information during events at places such as theatres.

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Lastly, older adults can learn to use their greater vocabulary, knowledge of the world and familiarity with the context of conversation topics to counteract age-related changes in how the brain processes sounds, Pichora-Fuller said.

Many hearing-loss centres offer programs designed to help older adults.

By learning to compensate for hearing decline, "older adults can continue to be successful in conversations and social interactions," she said.

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