Most people believe that hearing loss is a problem affecting only the very old. But according to recent estimates, about 28 million Americans suffer from significant hearing loss. Most alarming is the dramatic increase in hearing loss among younger people.

Hearing impairment becomes more common as people age. One study found that 60 percent of people between the ages of 73 and 84 had significant hearing impairment. Some evidence suggests that high blood pressure, diabetes, cardiovascular disease, and smoking may all worsen age-related hearing impairment.

The growth of hearing loss among younger people today is about two and a half times more frequent than in the past 25 years or so. Two likely causes are loud music (and the earphones that pump it directly into the ears) and a noisier environment.

There are two main causes of hearing loss: conductive and sensorineural. Conductive hearing loss results from abnormalities in the outer or middle ear that hinder the conduction of sound through the ear canal. This type of hearing loss can be most easily corrected by removing excessive buildup of wax in the outer ear and, if necessary, using a hearing aid.

But a more frequent type of hearing loss, and the most difficult to correct, is sensorineural, which is caused by abnormalities in the inner ear, the brain, or the nerve that carries impulses from the inner ear to the brain.

The following questions from the National Institute on Deafness and Other Communication Disorders will help you recognize hearing loss in yourself or others:

• Do you have a problem hearing over the telephone?
• Do you have trouble following the conversation when two or more people are talking at the same time?
• Do people complain that you turn up the TV volume too high?
• Do you have to strain to understand conversation?
• Do you have trouble hearing in a noisy environment?
• Do you find yourself asking people to repeat themselves?
• Do many people whom you talk to seem to mumble (or to speak unclearly)?
• Do you misunderstand what others are saying and respond inappropriately?
• Do you have particular trouble understanding the speech of women and children?
• Do people get annoyed because you misunderstand what they say?

A “yes” answer to three or more of these questions suggests you need an appointment with an ear, nose, and throat specialist (an otolaryngologist) or an audiologist for a hearing evaluation.

Unfortunately, no treatment exists to repair hearing loss. A hearing aid can amplify the sound and help some people with a significant conductive impairment. But these devices are expensive and sometimes uncomfortable — and some people’s brains never do adjust fully to the new way things sound. Yet these aids are still the most effective devices available for improving hearing.

Hearing aids are even less effective at improving sensorineural hearing loss. Cochlear implants, however, can help people whose severe hearing loss in both ears is not improved with hearing aids.

Often overlooked as a serious health problem, hearing loss can significantly reduce a person’s quality of life when it hampers communication and leads to social isolation and even depression. Don’t ignore your hearing. Act now to protect this important connection to the world around you.