COLUMBIA, SOUTH CAROLINA — Older adults who maintain higher levels of physical function may also be more likely to retain better hearing, according to a new study from researchers at the University of South Carolina and collaborating institutions.
Published in Scientific Reports, the study examined the relationships among physical function, systolic blood pressure, hearing sensitivity, and cognition in 150 community-dwelling adults between the ages of 50 and 80. The results showed a significant association between better physical function and lower hearing thresholds, indicating better hearing sensitivity.
Importantly, the association was not explained by systolic blood pressure. Although blood pressure increased with age, it did not appear to mediate the relationship between physical function and hearing in the study population.
Examining Links Between Healthy Aging and Hearing
Age-related declines in physical, sensory, and cognitive function have often been attributed, at least in part, to shared cardiovascular factors. The researchers tested whether systolic blood pressure might serve as one pathway connecting physical function with hearing and cognitive outcomes.
“Aging has long been associated with decreases in physical, sensory, and cognitive functions, and scientists and clinicians previously assumed that cardiovascular health was the common underlying factor in these declines,” said Jean Neils-Strunjas, Ph.D., chair of the Department of Communication Sciences and Disorders at the University of South Carolina and lead author of the study.
“However, our research showed that systolic blood pressure — a measure of cardiovascular health that increases with age — did not appear to impact hearing loss, while physical function seemed to have a protective effect in the group we studied, which was comprised mostly of educated women”
The researchers used data from the university’s Aging Brain Cohort, an ongoing project that collects behavioral, neuroimaging, genetic, and other health information related to aging. Participants completed assessments of hearing, cognition, blood pressure, and physical function.
Hearing sensitivity was measured using pure-tone audiometry across frequencies from 250 Hz through 8,000 Hz in both ears. Cognitive performance was evaluated using the Montreal Cognitive Assessment, while physical function was measured with the RAND 36-Item Health Survey.
The physical-function questionnaire asked participants how much their health limited everyday activities, including walking, climbing stairs, performing moderate or vigorous exercise, and completing personal-care tasks. Higher scores indicated fewer physical limitations.
Better Physical Function Associated With Better Hearing
After accounting for age and sex, higher physical-function scores were significantly associated with better hearing thresholds. The researchers estimated that every 10-point increase in physical-function score corresponded to an average 1.35 dB HL improvement in hearing threshold.
The effect was modest. The authors noted that a 30-point difference in physical function would correspond to approximately a 4 dB HL difference in hearing. However, they said even relatively small differences could have meaningful implications at the population level because hearing loss is so common among older adults.
Age remained a strong predictor of both blood pressure and hearing. On average, every 10-year increase in age was associated with a 7.5 mm Hg increase in systolic blood pressure and an 8.78 dB HL increase in hearing threshold. Male participants also had poorer hearing than female participants, with average thresholds approximately 4.9 dB HL higher.
By contrast, systolic blood pressure was not significantly associated with either hearing thresholds or cognitive performance in the study. Physical function also had only a minimal association with cognition, and that relationship was not explained by blood pressure.
“These findings suggest that systolic blood pressure does not appear to be a meaningful predictor of hearing loss or cognitive performance in healthy older adults,” Neils-Strunjas said.
“When taken together with the positive association between physical function and hearing, our research indicates that targeting physical activity directly — rather than relying solely on blood pressure management — could help preserve hearing and cognitive health. Aside from these findings, we recommend that anyone with high blood pressure consult their medical provider.”
Possible Mechanisms and Clinical Implications
The findings do not establish that physical activity directly prevents hearing loss. Because the study was cross-sectional, researchers measured participants at one point in time and could not determine whether better physical function led to better hearing, whether hearing status influenced activity, or whether other underlying factors affected both.
Nevertheless, the authors identified several possible pathways through which physical activity and physical function might support auditory health. These include improved vascular function and blood flow, reduced inflammation and oxidative stress, better metabolic regulation, improved mitochondrial health, and protection against microvascular damage within the cochlea.
The absence of a clear role for systolic blood pressure also suggests that a single cardiovascular measurement may not fully represent the physiological factors affecting hearing. Future studies could examine broader measures of cardiovascular health, inflammatory activity, metabolic function, immune health, and neurotrophic support.
For clinicians, the findings support a broader approach to healthy aging that considers mobility and physical function alongside hearing, cognition, and cardiovascular health. Assessing physical limitations may also help identify older adults who could be at greater risk of hearing impairment.
Important Study Limitations
The authors cautioned that the findings may not apply equally to all older adults. The sample was 74% female, nearly 99% White, and highly educated, with 84% of participants reporting at least a college-level education. Participants were also generally healthy and had average hearing and cognitive scores within normal ranges.
Physical function was based on self-report rather than direct measurements such as gait speed, strength, or accelerometer-recorded activity. The relatively small sample size and differences in participants’ use of blood-pressure medications also limited the analysis.
The Aging Brain Cohort is collecting five-year follow-up data, which may help researchers determine whether changes in physical function over time are accompanied by changes in hearing.
While additional research is needed, the study adds to growing evidence that maintaining mobility and an active lifestyle may contribute to healthier sensory aging, including the preservation of hearing.
Reference
Neils-Strunjas J, Arjmandi M, Hajihosseini M, et al. Physical function impacts hearing without mediation from systolic blood pressure. Scientific Reports. 2026. https://doi.org/10.1038/s41598-026-55494-w
Source: Scientific Reports, USC
