Hearing Loss and Fall Risk: More Questions than Answers

Last week I posted a short blurb about a recent Johns Hopkins study linking hearing loss and fall risk. The study claims that people with even mild hearing loss have a three times greater risk of falling, and that the risk increases as the hearing loss increases. Well, I operate a practice called Blue Ridge Hearing and Balance Clinic, and one can rightfully assume that we see patients with hearing problems, and with balance problems, and not uncommonly, with both hearing AND balance problems.

But what is the association, other than the fact that most of our patients are elderly? Obviously, vascular conditions such as diabetes and ear conditions such as Meniere’s disease and Labyrinthitis affect both hearing and balance. The authors reportedly accounted for these factors, and still found a strong association.

So, what do we make of this? We see patients every day with dysfunctional vestibular systems, but with perfectly normal hearing, and vice versa. Should we suggest that all our hearing impaired patients undergo a vestibular function evaluation or fall risk screening? Should we counsel our vestibular patients that treating their hearing loss will reduce their fall risk? Is that even true? Why are we just now making this connection? Why is “hearing loss” not listed as a risk factor for falling if there is such a close association? Could it be that very few fall prevention studies are done by audiologists, therefore hearing ability is not usually assessed? Is there causation as well as association? Anybody?

My head is spinning. No pun intended. (Okay, maybe a little).

 

About Alan Desmond

Dr. Alan Desmond is the director of the Balance Disorders Program at Wake Forest Baptist Health Center, and holds an adjunct assistant professor faculty position at the Wake Forest School of Medicine. In 2015, he received the Presidents Award from the American Academy of Audiology.