Pathogenesis of Age-Related Hearing Loss and Therapeutic Strategies

Age-related hearing loss (ARHL) is a degenerative disorder of the auditory system, characterized by bilateral symmetrical sensorineural hearing loss that occurs with aging. As a highly prevalent age-related condition worldwide, ARHL significantly impairs both the quality of life and mental health of the elderly. The pathogenesis of ARHL involves multifactorial mechanisms, with primary pathological features including elevated hearing thresholds, loss of hair cells, degeneration of spiral ganglion neurons, and damage to the stria vascularis. In this review, we summarize the pathogenesis of ARHL, which includes oxidative stress, DNA damage, and inflammation, ultimately contributing to the activation of cell death pathways such as apoptosis, ferroptosis, and pyroptosis. Building upon this mechanistic understanding, preventive strategies focus on minimizing exposure to environmental risk factors such as chronic noise, tobacco, and alcohol consumption. Current therapeutic approaches primarily involve pharmacological interventions targeting oxidative stress, hormonal therapies, and emerging gene-editing technologies. Notably, regenerative medicine strategies that utilize stem cell-based technologies to reconstruct cochlear hair cells represent a promising therapeutic direction for future research. In conclusion, a deeper understanding of the multifaceted mechanisms underlying ARHL holds significant promise for developing targeted preventive and therapeutic strategies to improve auditory health and quality of life of the elderly.