Aging Changes in the Senses: What Older Adults Should Know

Understanding aging changes senses seniors is important for seniors and their caregivers. as you age, the way your senses (hearing, vision, taste, smell, touch) give you information about the world changes. You may have problems communicating, enjoying activities, and staying involved with people. Your senses become less sharp, and this can make it harder for you to notice details.

Sensory changes can affect your lifestyle. This information can be in the form of sound, light, smells, tastes, and touch. Sensory changes can lead to isolation.

Your senses receive information from your environment. There, the signals are turned into meaningful sensations.

A certain amount of stimulation is required before you become aware of a sensation. Sensory information is converted into nerve signals that are carried to the brain. Aging raises this threshold. This minimum level of sensation is called the threshold. Devices such as glasses and hearing aids, or lifestyle changes can improve your ability to hear and see.

HEARING

Your ears have two jobs. You need more stimulation to be aware of the sensation.

Aging can affect all of the senses, but usually hearing and vision are most affected. Hearing occurs after sound vibrations cross the eardrum to the inner ear. One is hearing and the other is maintaining balance. Fluid and small hair in the inner ear stimulate the auditory nerve. The vibrations are changed into nerve signals in the inner ear and are carried to the brain by the auditory nerve.

Balance (equilibrium) is controlled in the inner ear. Your ability to pick up sounds decreases. This helps the brain keep your balance.

As you age, structures inside the ear start to change and their functions decline. It affects both ears equally. You may also have problems maintaining your balance as you sit, stand, and walk.

Age-related hearing loss is calledpresbycusis. You may also have trouble telling the difference between certain sounds. Hearing, particularly the ability to hear high-frequency sounds, may decline. If you are having trouble hearing, discuss your symptoms with your health care provider. Or, you may have problems hearing a conversation when there is background noise. One way to manage hearing loss is by getting fitted with hearing aids.

Persistent, abnormal ear noise (tinnitus) is another common problem in older adults. Even mild hearing loss has been associated with a higher chance of developing dementia. If you have tinnitus, ask your provider how to manage the condition.

Impactedear waxcan also cause trouble hearing and is common with age. Causes of tinnitus may include wax buildup, medicines that damage structures inside the ear or mild hearing loss. Light passes through the transparent eye surface (cornea). Your provider can remove impacted ear wax.

VISION

Vision occurs when light is processed by your eye and interpreted by your brain. The pupil becomes larger or smaller to control the amount of light that enters the eye. It continues through the pupil, the opening to the inside of the eye.

It is a muscle that controls pupil size. The colored part of the eye is called theiris. The lens focuses light on yourretina(the back of the eye).

After light passes through your pupil, it reaches the lens. The cornea becomes less sensitive, so you might not notice eye injuries. The retina converts light energy into a nerve signal that the optic nerve carries to the brain, where it is interpreted.

All of the eye structures change with aging. The pupils may react more slowly in response to darkness or bright light. By the time you turn 60, your pupils may decrease to about one third of the size they were when you were 20.

The fat pads supporting the eyes decrease and the eyes sink into their sockets. The lens becomes yellowed, less flexible, and slightly cloudy leading to the development of cataracts. The most common problem is difficulty focusing the eyes on close-up objects.

The eye muscles become less able to fully rotate the eye.

As you age, the sharpness of your vision (visual acuity) gradually declines. Reading glasses, bifocal glasses, or contact lenses can help correct presbyopia.

You may be less able to tolerate glare. This condition is calledpresbyopia. You may have trouble adapting to darkness or bright light. For example, glare from a shiny floor in a sunlit room can make it difficult to get around indoors. Using warm contrasting colors (yellow, orange, and red) in your home can improve your ability to see. Problems with glare, brightness, and darkness may cause problems driving at night.

As you age, it gets harder to tell blues from greens than it is to tell reds from yellows. This can create small particles called floaters in your field of vision. Keeping a red light on in darkened rooms, such as the hallway or bathroom, makes it easier to see than using a regular night light.

With aging, the gel-like substance (vitreous) inside your eye starts to shrink. But if you develop floaters suddenly or have a rapid increase in the number of floaters, you should have your eyes checked by a professional, as this may indicate a retinal detachment.

Reducedperipheralvision (side vision) is common in older people. In most cases, floaters do not reduce your vision. It may be hard to communicate with people sitting next to you because you cannot see them well. This can limit your activity and ability to interact with others. It may be hard to look upward. Driving can become dangerous.

Weakened eye muscles may prevent you from moving your eyes in all directions. This leads to dry eyes which may be uncomfortable. The area in which objects can be seen (visual field) gets smaller.

Aging eyes also may not produce enough tears. You can relieve dry eyes by using eye drops or artificial tears.

The upper eyelids may sag because of weakened muscular support. When dry eyes are not treated, infection, inflammation, and scarring of the cornea can occur. Visual loss is associated with an higher chance of developing dementia.

TASTE AND SMELL

The senses of taste and smell work together. This may lead to visual loss if the sagging is severe.

Common eye disorders that cause vision changes that are NOT normal include:

– Cataracts– clouding of the lens of the eye
– Glaucoma– rise in fluid pressure in the eye
– Macular degeneration– disease in the macula (responsible for central vision) that causes vision loss
– Retinopathy– disease in the retina often caused by diabetes or high blood pressure

If you are having vision problems, discuss your symptoms with your provider. The sense of smell begins at the nerve endings high in the lining of the nose.

You have about 10,000 taste buds. Most tastes are linked with odors. Umami is a taste linked with foods that contain glutamate, such as the seasoning monosodium glutamate (MSG).

Smell and taste play a role in food enjoyment and safety. Your taste buds sense sweet, salty, sour, bitter, and umami flavors. Smell and taste also allow you to detect danger, such as spoiled food, gases, and smoke.

The number of taste buds decreases as you age. A delicious meal or pleasant aroma can improve social interaction and enjoyment of life. Sensitivity to the five tastes often declines after age 60. Each remaining taste bud also begins to shrink. This can cause dry mouth, which can affect your sense of taste.

Your sense of smell can also diminish, especially after age 70. In addition, your mouth produces less saliva as you age. Mucus helps odors stay in the nose long enough to be detected by the nerve endings. This may be related to a loss of nerve endings and less mucus production in the nose. These include diseases, smoking, and exposure to harmful particles in the air.

lower taste and smellcan lessen your interest and enjoyment in eating. It also helps clear odors from the nerve endings.

Certain things can speed up the loss of taste and smell. The following may help:

– Switch to a different medicine, if the medicine you take is affecting your ability to smell and taste. You may not be able to sense certain dangers if you cannot smell odors such as natural gas or smoke from a fire.

If your senses of taste and smell have diminished, talk to your provider. – Buy safety products, such as a gas detector that sounds an alarm you can hear. – Use different spices or change the way you prepare food. Skin, muscles, tendons, joints, and internal organs have nerve endings (receptors) that detect these sensations.

TOUCH, VIBRATION, AND PAIN

The sense of touch makes you aware of pain, temperature, pressure, vibration, and body position. Though you may not be aware of this information, it helps to identify changes (for example, the pain ofappendicitis).

Your brain interprets the type and amount of touch sensation. Some receptors give the brain information about the position and condition of internal organs. These changes can occur because of lower blood flow to the nerve endings or to the spinal cord or brain. It also interprets the sensation as pleasant (such as being comfortably warm), unpleasant (such as being very hot), or neutral (such as being aware that you are touching something).

With aging, sensations may be reduced or changed. Brain surgery, problems in the brain, confusion, and nerve damage from injury or long-term (chronic) diseases such as diabetes can also result in sensation changes.

Symptoms of changed sensation vary based on the type that is affected. The spinal cord transmits nerve signals and the brain interprets these signals.

Health problems, such as a lack of certain nutrients, can also cause sensation changes. This can increase the risk of injury fromfrostbite,hypothermia(dangerously low body temperature), andburns.

Reduced ability to detect vibration, touch, and pressure increases the risk of injuries, includingpressure ulcers(skin sores that develop when pressure cuts off blood supply to the area). With lower temperature sensitivity, it can be hard to tell the difference between cool and cold and hot and warm. Or, you may feel and recognize pain, but it does not bother you. After age 50, many people have reduced sensitivity to pain. This increases your risk of falling, a common problem for older people.

Older people can become more sensitive to light touches because their skin is thinner.

If you have noticed changes in touch, pain, or problems standing or walking, talk with your provider. For example, when you are injured, you may not know how severe the injury is because the pain does not trouble you.

You may develop problems walking because of reduced ability to perceive where your body is in relation to the floor. – Check the thermometer to decide how to dress, rather than waiting until you feel overheated or chilled. There may be ways to manage the symptoms.

The following measures can help you stay safe:

– Lower the water heater temperature to no higher than 120°F (49°C) to avoid burns. If you find an injury, treat it. – Inspect your skin, especially your feet, for injuries.

OTHER CHANGES

As you grow older, you will have other changes, including:

– In organs, tissues, and cells
– In skin
– In the bones, muscles, and joints
– In the face
– In the nervous system

– Aging changes in hearing
– Hearing aids
– Tongue
– Sense of sight
– Aged eye anatomy

Emmett SD. Do not assume the injury is not serious because the area is not painful. In: Flint PW, Francis HW, Haughey BH, et al, eds.Cummings Otolaryngology: Head and Neck Surgery. Otolaryngology in the elderly. Philadelphia, PA: Elsevier; 2021:chap 13.

Studenski S, Van Swearingen J. 7th ed. In: Fillit HM, Rockwood K, Young J, eds.Brocklehurst’s Textbook of Geriatric Medicine and Gerontology. Falls. Philadelphia, PA: Elsevier; 2017:chap 103.

Walston JD. 8th ed. In: Goldman L, Cooney KA, eds.Goldman-Cecil Medicine. Common clinical sequelae of aging. Philadelphia, PA: Elsevier; 2024:chap 24.

Updated by: Frank D. 27th ed. Also reviewed by David C. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Editorial team.

– Eye Diseases
– Hearing Disorders and Deafness
– Older Adult Health
– Taste and Smell Disorders Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M.