Is There a Connection Between Hearing Loss and Balance?

Research in the past decade as repeatedly concluded that untreated hearing loss is correlated with a myriad of medical, social, and cognitive problems. Recent research from Johns Hopkins School of Medicine has identified that untreated hearing loss is linked to another chief health concern: falls. In his article Hurt at Home and Fall is Likely to Blame in the New York Times, Nicholas Bakalar statedm, “The most common cause of nonfatal injury in every age group is falling down.” Moreover, falls are the leading cause of accidental death in adults over the age of 65. According to the Center for Disease Control, 20,000 elderly people suffered fatal injuries in 2009 from falls. Additionally, there were 2.2 million non-fatal injuries from falls. Medical costs incurred from falls are estimated to be approximately $30 billion per year.

Dr. Frank Lin (Johns Hopkins School of Medicine) and Dr. Luigi Ferrucci (National Institute on Aging) conducted a thorough review of data obtained from 2001 to 2004 from the National Health and Nutrition Examination Survey to best assess the possible correlation between hearing loss and increased risk of falls. During those years, over two thousand middle-aged participants had their hearing evaluated and answered questions regarding falls in the past year. The researchers collected other demographic and health information. They also assessed the participants’ vestibular function. Vestibular function is the inner ear balance system that provides sensory information about spatial orientation and head motion.

Drs. Lin and Ferrucci discovered that people with a 25-decibel hearing loss, classified as a mild degree of dysfunction, were nearly three times more likely to have a significant history of falls. Each additional 10-decibels of hearing loss increased the chances of falling by nearly one and half fold. These statistics remained unchanged when accounting for other factors linked with falling, including age, sex, race, cardiovascular disease, and vestibular dysfunction. Furthermore, the results did not waver when patients with moderate to severe hearing loss were excluded from the statistical analysis.

Dr. Lin proposed that people with hearing loss likely do not have adequate awareness to sound in their environment, making tripping and falling more likely. The brain must also maintain many demands with limited mental resources. So, he added that cognitive overload is likely another underlying reason for one’s propensity to fall when suffering from hearing loss. “Gait and balance are things most people take for granted, but they are actually very cognitively demanding,” Lin says. “If hearing loss imposes a cognitive load, there may be fewer cognitive resources to help with maintaining balance and gait.” This inability to maintain stability does not necessarily occur when an individual is physically fatigued. The mental weariness occurs relatively quickly if a person is in a demanding listening environment, such as a restaurant with significant background noise.

Another study was performed by researchers at Washington University who sought to determine if the use of hearing aids improved balance and if a lack of hearing aids would negatively affect one’s balance.

Participants’ eyes were covered, and they were given increasingly complex balance tests. Although a small number of subjects performed equally as well in the easier tests whether or not hearing aids were utilized, as the tests became more difficult all of the subjects displayed significant difficulty maintaining balance when the hearing aids were off. The results of this study indicate that auditory information alone plays a larger role in maintaining balance than was previously acknowledged. Therefore, the use of hearing aids does, in fact, make a significant improvement in patient’s ability to maintain balance and reduce falls.

“We don’t think it’s just that wearing hearing aids makes the person more alert,” said Dr. Timothy Huller, professor of otolaryngology. “The participants appeared to be using the sound information coming through their hearing aids as auditory reference points or landmarks to help maintain balance.”

Research has verified that untreated hearing loss costs millions of dollars each year. Injuries from falls add to these rising healthcare costs. Not every fall could be averted by use of hearing instruments, but these research studies strongly suggest that the use of appropriately set and utilized hearing aids could prevent falls and subsequently injuries and added medical expenses.

Today’s hearing devices incorporate sophisticated spatial sound processing that maintains a more natural representation of the environment while applying strong noise reduction capabilities to squelch unwanted distractions. So, it is no surprise that current hearing aids are proven to reduce cognitive load, increasing attention and overall brain function. With improved sound awareness and less listening effort, balance is improved and falls are reduced.

When it comes to national health and safety, not only for our elderly population, the importance of hearing cannot be underestimated. Current research consistently points to the need for all people to take their hearing health seriously. If you or a loved one wishes to take a proactive role in their hearing, balance, and overall health, contact our doctors of audiology for an evaluation.