Association of Hearing Loss and Falling
Written by: Dr. Matthew Seldine
Patient: “Does having a hearing loss increase my risk of falling?”
Answer: This question is asked of audiologists quite often. To begin, the answer is this – having a hearing loss significantly increases ones odds of falling. So yes, there is an association between having a hearing loss and experiencing a fall. Let’s expand on this topic.
The inner ear is the key. It is the home of the balance system (vestibular system) and the hearing system (cochlea). Both of these organs are housed together within the same structure and it is because of this shared location in the inner ear that the association may exist. If one organ is damaged then its neighbor might be as well. When our cochlea is damaged and hearing loss is the result, we lose the ability to detect valuable and important information about our environment. I’m sure everyone has experienced at one time or another hearing a sound and not knowing exactly where it came from. To a degree, this is normal. However, hearing loss makes it very difficult for the ears to accurately pinpoint the location of sounds since they are not able to accurately detect the sounds in the first place. Thus, detail about our environment will be lost and that can be very disorienting.
Researchers have sought to determine the mechanism(s) behind this association. Several could help explain it and two have already been discussed – a shared damage between the two inner ear organs and “decreased hearing sensitivity directly [limiting] access to auditory cues that are needed for environmental awareness.”
The third mechanism may be the most important, especially for the elderly population. With any amount of hearing loss an increased cognitive load is experienced. In other words, the brain has to work harder than normal to sift through auditory information and make sense of it. The effect? Reduced attentional resources for other tasks – in our case here, maintaining balance and posture. Retaining attentional resources is crucial for maintaining postural control. As hearing loss is determined and progresses, more and more brainpower is required to “hear” and “listen” and fewer and fewer resources may be available for other tasks, like establishing and maintaining postural control, thereby increasing the risk of falling.
As a closing aside, it is extremely important to maintain good postural control and balance as falls have been labeled the leading cause of accidental death in adults over the age of 65 according to the Center for Disease Control. Falls continue to be a leading area of concern for national safety and health, especially for our senior population. Being proactive in identifying any nature of balance concerns is ideal in order to take appropriate action and help correct and manage the situation, and ultimately strengthen quality of life.
http://www.healthyhearing.com/report/52548-New-research-links-hearing-loss-to-an-increasedrisk-of-falls Lin, F. R. & Ferrucci, L. (2012). Hearing Loss and Falls Among Older Adults in the United States. Archives of Internal Medicine, 172(4), 369-371.