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Posted on Thursday, January 09, 2014

Hearing Loss and the Risk of Unexpected Falls

This woman on a tightrope symbolizes that hearing and balance are related.

In a recent study conducted by Johns Hopkins and funded by the National Institute of Health, untreated hearing loss has been linked to an increased likelihood of falls. Even people with mild hearing loss were shown to have a greater chance of losing their balance. This correlation has surprised some people and confused others. So how is hearing related to balance and what are some of the reasons for the greater likelihood of falling because of hearing loss?

There are three main sections of the ear--outer, middle, and inner. These divisions work in conjunction with the brain to decipher signals and determine the position of the head. Balance is a complicated process involving other parts of the body, but one of the most crucial parts is the one found within the inner ear. The vestibular systems within the inner ear keeps track of the movements of the head and reports them to the brain. So when there is a problem with fluid in the ears, like with Meniere's disease, balance can be affected as well as hearing. Knowing this it might seem obvious why people who have hearing loss are more likely to fall, but surprisingly the results of the study held true even when problems with vestibular functions were excluded from the study. So what might be the other reasons for this increased likelihood of falls?

Another reason hearing loss might increase the risk of falls is cognitive load, in which the brain is overwhelmed with demands on its limited resources. Co-author of study, Dr. Frank Lin of Johns Hopkins

Cognitive overload is a condition in which a person with untreated hearing loss is mentally fatigued through the extra effort needed to concentrate and pay attention to speech in their everyday environment. “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 focus on balance and gait is not something that happens when an individual is physically fatigued. The cognitive exhaustion or listening lethargy can happen relatively quickly if a person is in a demanding listening environment. Demanding listening environments include those with high background noise or poor acoustics.

Lack of awareness of environment can cause misperceptions in spatial reasoning.

According to Healthy Hearing.com, "Sound arrives at one ear a split second before it reaches the other ear on the other side of your head. The split second sound delivery time enables the hearing centers of the brain to determine the location of source of the sound--a throwback to our prehistoric ancestors who needed to know the location of the dangers around them." Dr. Lin, an otologist and epidemiologist, says among the possible explanations for the link is that people who can’t hear well might not have good awareness of their overall environment, making tripping and falling more likely.

Every year about 33 million Americans are injured badly enough to require medical attention, and the most common cause of nonfatal injury in every age group is falling down. Nicholas Bakalar, Hurt at Home, And Fall is Likely to Blame, The New York Times

According to the CDC, "In 2000, the direct medical cost of fatal fall injuries totaled $179 million. On average, the hospitalization cost for each fall injury is $18,000." Untreated hearing loss costs millions each year, and falls add to these rising costs. Obviously not all of these incidents could be prevented by use of a hearing aid, but treating hearing loss does benefit some of the areas thought to cause falls. Hearing aids have been shown to help with cognitive overload, increasing attention and brain functions. Today's hearing aids also incorporate spatial and locational technologies to give wearers the same organic awareness of environment as natural hearing, and also have the ability to eliminate background noise.

Today's evidence consistently points to the need for all people to take their hearing health seriously. If you'd like to learn more about hearing loss or have your child tested for hearing loss, see your hearing health provider. If you need help finding a hearing health provider click HERE to be connected with the largest network of trusted hearing health professionals in the nation!

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