Ladies and Gentlemen, over the past few months, I have helped to increase your awareness of fall risk factors that occur as part of physical changes related to aging gracefully each and every day. Samples of these topics that have been covered include: orthostasis – dropping blood pressure with sitting-up and/or standing-up and visual changes, such as macular degeneration, glaucoma, and cataracts. I have also included strategies to reduce your risk related to these aging changes by engaging your Harmony Team, primary care provider, and practical strategies that you can implement. While some risk factors, such as orthostasis and vision problems, can be modified or eliminated through treatments, exercises, medications, or special procedures, other risk factors require compensatory strategies and devices through the use of technology and equipment. What is common, is that many fall risk factors can be treated or compensated for, one way or another!
Such a fall risk factor that can be modified through treatment and/or compensatory strategies is:
Everyone knows that hearing loss can affect our social functioning and quality of life. When hearing declines, you can miss out on conversations, frequently have to ask people to repeat what has been said, increase the volume on our television, radio, or computer, or become withdrawn.
But…..Did you know that hearing loss is associated with increased fall risk?
Aging is the most important risk factor for hearing loss (United States Preventive Services Task Force, 2013). Estimates suggest that 15% of adults have a hearing loss (Blackwell, Lucas & Clarke, 2014), and CDC (2015) reported that 43% of adults 70 and older, who do not have hearing aids, self-reported difficulty hearing. One of the disorders, presbycusis, is a gradual, progressive decline in our ability to perceive high frequency tones due to degeneration of hair cells in the ear. This problem is the most common cause of hearing loss in older adults. Other causes of hearing loss can result from a history of exposure to loud noises, toxic agents and medications to the ear, recurring ear infections and certain systemic diseases, such as diabetes (American Speech-Language Hearing Association [ASHA]).
ASHA (2011) recommends that adults be screened for hearing status at least every decade through the age of 50. After then, ASHA recommends that adults are screened at 3-year intervals. Why? Because hearing loss can be subtle with aging, with the loss of higher range decibels that reduce our ability to hear high pitches, understand speech, have ringing the ears, and more. These reductions may be so subtle that when asked, “do you have difficulty with your hearing”, one may say “no”. This one question is the frequent screening question used to detect hearing in adults, which is why a clinical hearing test is important. The value of a clinical test, such hear a watch ticking, fingers rubbing next to your ear, or an audiology exam which is diagnostic, provides you with the most helpful information to decide on treatment and interventions.
In 2012, Lin and Ferrucci, researchers at the Johns Hopkins School of Medicine and the National Institute of Aging, studied adults 40-69 years of age and examined their hearing and vestibular function. The inner ear’s vestibular system provides sensory information to our brain about our body position in space, motion and equilibrium. Of those they studied, 14.3% had hearing loss greater than 25 decibels and 4.9% reported a fall in the last year. The researchers also found that even a mild decree of hearing loss tripled the risk of an accidental fall, with the risk increasing by 140% for every additional 10 decibels of hearing loss. Yes, these researchers discovered that hearing loss increases the risk of falls for older people by a significant amount.
Lin and Ferrucci speculated that fall risks increase with hearing loss because there is less environmental awareness to people, pets, or other things around you. Loss of spatial awareness is another possible reason – knowing where your body is in relation to other people of objects. Their third reason suggested for increased fall risk is that you have fewer cognitive resources to maintain your balance when you are working overtime to hear sounds and interpret speech and conversations. Hearing loss does affect function, interaction and safety.
Lin and Ferrucci also investigated if hearing aids could help improve balance, validating the benefit of hearing aids in reducing falls. They found that hearing aids did make such a definitive difference in balance in higher level tests, such a maintaining balance when your eyes are closed or walking heel-to-toe. In other words, when balance is improved, fall risks are decreased.
I’m sharing this information with you because not all hearing tests result in the need for a hearing aid. I know many older adults are embarrassed to wear a hearing aid, or will stop wearing it over time. Ladies and Gentlemen, ear infections can be treated and ear canals can be cleaned – these are examples of modifiable conditions. However, loss of hearing can be treated with a hearing aid if needed. A hearing aid will improve your hearing, communication, social engagement, and reduce your fall risks. But of course, it has to be worn!
So, if you have not had a hearing test within the last 3 years, or you have noticeable decreases in your hearing, let your primary provider know, talk with your Harmony Team, and have your hearing checked. Hearing screening is an important component of healthcare management, remaining independent and reducing your risk of falls. You may be surprised to learn how much you are missing.
I hope this message is helpful to you and provides you with encouragement to have your hearing tested as an important health practice that also reduces your fall risks.
As always, stay safe, strong, active, and connected with your healthcare team.
Your Harmony Team is here to help you!
Thank you for reading this message.
American Speech-Language Hearing Association. Adult hearing screening. Accessed 10/14/20 at https://www.asha.org/PRPSpecificTopic.aspx?folderid=8589942721§ion=Key_Issues
American Speech-Language-Hearing Association. Hearing Screening and Testing. Rockville, MD: American Speech-Language-Hearing Association; Feb 8, 2011. 2011. Accessed 10/14/20 at http://www.asha.org/public/hearing/Hearing-Testing/
Blackwell DL, Lucas JW, Clarke TC. Summary health statistics for U.S. adults: National Health Interview Survey, 2012 (PDF). National Center for Health Statistics. Vital Health Stat 10(260). 2014. Accessed 10/14/20 at https://www.cdc.gov/nchs/data/series/sr_10/sr10_260.pdf
Centers for Disease Control and Prevention. Self-reported hearing trouble in adults aged 18 and over. United States, 2014. NCHS Data Brief No. 201. September 2025. Accessed 10/15/20 at https://www.cdc.gov/nchs/products/databriefs/db214.htm
Lin, F., & Ferrucci, L. (2012). Hearing loss and falls among older adults in the United States.
Arch Internal Med, 172(4): 369-371. Accessed 10/15/20 at
U.S. Preventive Services Task Force. Screening for hearing loss in older adults: Recommendation statement. Am Family Physician, 2013, Jan 15;87(2). Accessed 10/15/20 at https://www.aafp.org/afp/2013/0115/od1.html