We all know that aging brings an increase in many risks. Foremost among these is falling. Seeing that a serious fall can be a life-altering event, prevention of falls is critical.
Since the ear functions for both hearing and balance, it is reasonable to suspect that those with hearing loss may have an increased risk of falling. Studies have shown that this is the case. A 2017 study by Dr. Frank Lin from the Johns Hopkins School of Medicine and Luiggi Ferrucci from NIOA, “Hearing Loss and Falls Among Older Adults in the United States”, found that the presence of a hearing loss increased the likelihood of falls. This was evident in people with even a mild loss and more significant as the hearing loss worsened.
We use our hearing to be alert to activities, people, and pets within our immediate environment and to help maintain good spatial awareness. With hearing loss, auditory cues are less salient, requiring more mental effort in order to function well. This in turn means there is less mental effort available for other tasks such as maintaining balance.
A smaller study by Dr. Timothy Heller from Washington University of St. Louis demonstrated that using hearing aids helps with balance. People with hearing loss were better able to do maintain their balance when they used hearing aids than without hearing aids.
Another research study conducted by the University of Michigan analyzed data covering about 115,000 seniors who were newly diagnosed with hearing loss. It found that 13 percent had an injury in a fall within three years, compared to 7.5 percent of the general population their age.
How Hearing Loss May Increase Risk of Falling
Hearing requires brainpower.
If you’re concentrating harder to interpret sound, you may have fewer mental resources available for balance. “Gait and balance are things most people take for granted, but they are actually very cognitively demanding,” says otologist Frank Lin, MD, Ph.D., from the Johns Hopkins School of Medicine.
What you hear (and don’t hear) directly affects your balance, according to a research overview led by Anat Lubetzky, Ph.D., assistant professor in the Physical Therapy Department at New York University, with a team at New York Eye and Ear Infirmary.
Hearing and balance are significantly affected by aging.
Age-related hearing loss may be linked to declines in the vestibular sense, a set of receptors in your inner ear, which comes into play whenever you move your head. It’s also activated by the downward force of gravity, giving you a sense of where you are: your grounding. If you’ve ever had an infection of the inner ear, you’ll recall you were dizzy.
However, you don’t need to be dizzy to have vestibular issues. Some evidence suggests the vestibular sense may begin to decline at about the age of 40. More than a third of all Americans older than 40 are unable to pass a balance test—standing on foam with their eyes closed—which is linked to a higher risk of falling.
Loud low-frequency sounds (think pounding drums) may damage the inner ear, over time affecting our balance (and hearing).
To be clear, age-related hearing loss and inner ear problems are not the same thing and don’t always occur simultaneously. According to Lubetzky, “Many people with vestibular disorders have excellent hearing and not all people with hearing loss will have vestibular weakness.”
We need sound to help us balance.
If you try to balance on one leg in a yoga class, for example, your teacher will tell you to stare at one spot. Stable sounds may work the same way as a kind of “auditory anchor.” But you have to hear them.”
This process may be especially important if you have hearing loss. For example, when people with hearing loss hear stable background sounds, their posture improves.
Balance arises from the contributions of several senses: vision, the coordination between our head and our eyes, our muscle and joint coordination—and, possibly, what we hear.
Hearing loss is linked to mood.
People may be less alert when caught up in a fog of misery or anxiety. Hearing loss increases the risk of depression. Depression is linked to more falls and those falls tend to deepen depression in another classic bad cycle.
Can Hearing Aids Help With Fall Prevention?
The University of Michigan study found that a first-time hearing-aid cut the risk of a fall-related injury by 13 percentage points in the next three years.
Research has not yet supported the idea that people are more stable when wearing hearing aids. But it’s possible that treating “hearing loss (with hearing aids or other implants) will also serve as a type of ‘balance aid’ like a cane,” says otolaryngologist Maura Cosetti, MD, co-author of the New York Eye and Ear Infirmary study.
The bottom line: If you’re concerned about your balance and you have hearing loss, hearing better may make a difference.
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