Early signs of hearing loss in adults: a checklist for you and family

The early signs checklist

Hearing loss rarely announces itself. It shows up as small frictions in daily life. Here are the signs that ASHA, FDA and MedlinePlus list for adults ^[2][3][8]. Count how many apply.

In conversation

• You ask people to repeat themselves a lot ^[2][8]
• Other people seem to mumble ^[2]
• You have trouble telling apart sounds like "s" and "th" ^[8], or hearing consonants in general ^[2]
• Higher-pitched voices are harder to understand ^[2][8]

In noise and groups

• Restaurants, parties and family dinners are hard to follow ^[2][3]
• You feel left out when several people talk at once ^[1]
• You avoid social settings or skip activities you used to enjoy ^[2]

With devices

• You turn up the TV or radio louder than others want it ^[2][3]
• Phone calls are a struggle ^[2][3]

How it feels

• Listening leaves you tired ^[2][3]
• Hearing seems muffled ^[2]
• You hear ringing, buzzing or other sounds in your ears ^[2][8]
• Others tell you that you're talking too loudly or too softly ^[2]

Everyone mishears now and then. A pattern that keeps growing is worth a test.

Why gradual hearing loss hides

It comes on slowly. NIDCD notes that because age-related loss is gradual, you may not realize you've lost some of your ability to hear ^[1]. People adjust, sit closer to the TV and lean on context to fill gaps.

Your own rating isn't reliable. In a CDC study of national hearing tests, 23.5% of adults who described their hearing as excellent or good had signs of noise damage ^[4].

Doctors may not ask. The same CDC report cites studies finding that 40% to 77% of primary care providers had not asked about or screened for hearing loss, and that only 46% of adults with hearing trouble had seen a health care professional about it in the past five years ^[4].

Routine screening isn't settled. The U.S. Preventive Services Task Force concluded that for adults 50 and older with no signs or symptoms, the balance of benefits and harms of screening "cannot be determined" ^[6]. That's a statement about people without symptoms. If you notice signs, it doesn't apply to you, and you'll often need to raise hearing yourself.

And people wait. A study that followed adults for 28 years found an average of 8.9 years between when someone met the hearing-test criteria for hearing aids and when they got them ^[5].

How common is it? In a 2018 national survey, 17.8% of adults aged 45 to 64 reported trouble hearing, rising to 31.6% at 65 to 74 and 47.2% at 75 and older ^[2]. NIDCD puts it simply: about one in three people aged 65 to 74 has hearing loss ^[1]. For more on how it progresses, see age-related hearing loss.

What family members notice first

Because the loss is gradual, the person with it may be the last to notice ^[1]. Here are patterns spouses and adult children may see, matched to the signs above:

What family sees	What it may point to
Arguments over TV volume	Needing more volume than others [2][3]
"Stop mumbling" complaints	Speech sounding mumbled [2]
Nodding along, then answering the wrong question	Missing consonants and words [2]
Quiet at family dinners, leaving gatherings early	Trouble in noise and groups; avoiding social settings [2]
Missing the doorbell, phone or smoke alarm	NIDCD lists these as everyday risks of hearing loss [1]
Handing you the phone to "translate"	Trouble understanding speech on the phone [2]
More frustration or irritability in conversation	MedlinePlus lists frustration at not hearing as a symptom [8]

How to bring it up. Choose a quiet time, not the middle of a misunderstanding. Describe what you've seen ("You missed most of what Sam said at dinner") instead of a diagnosis. Suggest the self-check below as a low-pressure first step, and offer to go to the appointment.

Small changes help right away. NIDCD suggests family members face the person when talking, so they can see expressions and lip movements ^[1].

Take the self-check

NIDCD's hearing questionnaire asks about everyday situations: following TV or radio, hearing at parties, frustration in family conversations, feeling left out in groups and avoiding groups. Its rule: if you answer "yes" to two or more questions, or "sometimes" to three or more, get your hearing checked ^[1].

Our free hearing self-check asks ten similar everyday questions plus a short red-flag list, and takes about two minutes. Your answers stay in your browser. It doesn't replace a hearing test, but it can help you decide whether to book one, and it's an easy thing to send a parent.

When to book a hearing test, and how fast

Not every sign carries the same urgency. Use this table.

Situation	What to do
Sudden hearing loss in one or both ears, over hours to a few days	Treat it as an emergency and see a doctor today [7]. Read what to do about sudden hearing loss.
Hearing loss with headache, vision changes or dizziness	Contact a provider right away [8]
Worse hearing or ringing in one ear only; ear pain; fluid or blood from the ear; hearing that comes and goes	See a doctor, preferably an ENT, before trying an over-the-counter hearing aid [3]
Trouble hearing speech even in a quiet room	See a hearing professional; FDA says this goes beyond what OTC devices are for [3]
Gradual signs from the checklist, or a positive self-check	Book a hearing test; it isn't an emergency, but don't put it off [1]

Why not just wait? Untreated hearing loss can make it hard to follow a doctor's advice, respond to warnings and enjoy time with family, and can lead to isolation ^[1]. NIDCD also warns that people with sudden loss sometimes delay care by blaming allergies, a sinus infection or earwax, which can make treatment less effective ^[7].

What happens next

The test itself is painless. A full hearing evaluation looks at how well you hear tones and understand speech, and checks your ear canal and eardrum. Our guide to what happens at a hearing test walks through each step.

You may not need prescription hearing aids. If your signs match mild to moderate loss, such as trouble in noise or on the phone, FDA says over-the-counter hearing aids are an option for adults 18 and older ^[3]. A hearing test still helps you know what you're dealing with. See our guide to OTC hearing aids.

Bring notes. Write down the situations where you struggle most, such as restaurants, phone calls or the TV. Note whether one ear seems worse, any ringing, the medicines you take, and your history of loud noise at work or from hobbies like shooting or power tools. A provider will also check for medical causes and look in your ears, since earwax can block the ear canal ^[8].

Bring a family member. A second set of ears helps you remember what the provider says, and they can describe the situations they've noticed. If the test shows normal hearing, you have a baseline to compare against later. If it shows loss, you'll know its type and degree, which is what decides the next step.

Ready to book? Find a hearing provider near you.