# Presbycusis (age-related hearing loss)

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class HD68 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Presbycusis - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK559220/
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
PRESBYCUSIS (AGE-RELATED HEARING LOSS)
Sources: ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class HD68 -
         condition scope only, no dose · No dose - referral pathway, no medicine given in primary
         care · Presbycusis - StatPearls - NCBI Bookshelf -
         https://www.ncbi.nlm.nih.gov/books/NBK559220/
Review status: REVIEWED against the source listed above  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (3)
    - Family or friends often notice the hearing loss before the patient does  [hearing loss]
    - Trouble following speech in a noisy room is a typical early complaint
    - Tinnitus is sometimes reported but is not specific to this condition  [tinnitus]
  SIGNS - what you find (4)
    - Age-related tympanic membrane opacification and cerumen buildup are common incidental findings
    - Sound carried by air outlasts sound carried by bone on Rinne testing in each ear, consistent
      with a sensorineural pattern
    - Weber testing lateralizes toward the better-hearing ear, reflecting a contralateral
      sensorineural loss
    - Symmetric hearing loss can make Weber testing falsely appear normal  [hearing loss]
  TESTS (5)
    - Routine bedside exam maneuvers alone cannot establish the diagnosis; formal audiometry is
      required
    - An audiogram plots hearing threshold in decibels against frequency in hertz
    - Bilateral hearing loss above 2000 Hz on a down-sloping audiogram is characteristic
    - Imaging is reserved for cases where the presentation and audiometry disagree, or a neurologic
      finding is present
    - Labs for dyslipidemia, diabetes, and kidney dysfunction may be reasonable though not required
      to diagnose it
  IF NOT THIS - what else fits (4)
    - A diagnosis of exclusion: rule out noise damage, infections, Ménière disease, prior injury,
      autoimmune conditions, a perilymph leak, inherited loss, otosclerosis, a tumor, or ototoxic
      drugs first
    - If it's conductive rather than sensorineural, look instead for otosclerosis, a cholesteatoma,
      perforation, infection, a foreign body, tumor obstruction, or earwax impaction
    - Comorbid diabetes, hypertension, kidney impairment, and high lipids often travel with this
      diagnosis and merit evaluation
    - New mood or cognitive changes in an older adult may actually reflect unrecognized hearing
      impairment rather than a primary psychiatric or cognitive disorder
  Source  StatPearls "Presbycusis" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    Age-related sensorineural hearing loss has no drug treatment; management is audiology
            referral for hearing-aid assessment and counselling on communication strategies. -
            Refer, with advice
   Peds     Adult-only condition - paediatric section not applicable
   Source   No dose - referral pathway, no medicine given in primary care
   Why      Age-related sensorineural hearing loss has no drug treatment; management is audiology
            referral for hearing-aid assessment and counselling on communication strategies.
   Caution  Asymmetric or rapidly progressive loss, or loss accompanied by ear pain or discharge, is
            not typical presbycusis and needs ENT referral to exclude another cause.
            No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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