Hearing Loss and Falls—They Are Tied Together

Friday, February 19, 2016

GoLocalWorcester Health Team

"Human walking is a unique activity during which the body, step by step, teeters on the edge of catastrophe." says paleoanthropologist John Napie. So what keeps us from simply falling over? If you’ve ever had a bout of vertigo or dizziness or inexplicably lost your balance, you know the feeling that comes over you – one of not knowing which way is up or down. Even that awful nauseous feeling that has nothing to do with something you ate. So what keeps us upright? Our hearing! Well, the complex vestibular system, to be more precise, and hearing loss can create – yes, a cascade of catastrophe.

Balance depends on nerve signals from three systems -- eyes, legs/torso, and inner ear balance organs -- that comprise our vestibular system. The hearing and balance systems are connected inside the inner ear. Nerve signals, which go to the brain, help us to stay upright. If something goes wrong with one of these three systems, it can make us lose our balance.

Our vestibular system prevents us from falling forward, and helps us to simply stand upright. It lets our brain know how and where our head is moving. It’s been described as akin to multiple gyroscopes, much like those used to tell a pilot where, in space and time, the plane is flying.

When things go wrong.

According to the National Institute on Deafness and Other Communication Disorders (NIDCD), if you have a balance disorder, you may stagger when you try to walk, or teeter or fall when you try to stand up. You might experience other symptoms such as:

- Dizziness or vertigo (a spinning sensation)
- Falling or feeling as if you are going to fall
- Lightheadedness, faintness, or a floating sensation
- Blurred vision
- Confusion or disorientation

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Other symptoms might include nausea and vomiting, diarrhea, changes in heart rate and blood pressure, and fear, anxiety, or panic. Symptoms may come and go over short time periods or last for a long time, and can lead to fatigue and depression. Ruling out hearing loss or ear disorders is one of the first steps in a differential diagnosis.

A study from John Hopkins and the National Institute on Aging finds that even a mild hearing loss triples the likelihood of falling. With every 10-decibel increase in hearing loss, the risk of falling rises by an additional whopping 140%. Hearing loss reduces the awareness of the environment and researchers suspect hearing loss places extra demands on the brain’s resources, distracting the brain from carrying out other tasks, such as maintaining balance and walking. But falling is not an inevitable part of aging, and shouldn’t be simply accepted as an occurrence of getting older.

With corrected hearing, sounds in the environment that can warn of danger are more noticed, and the senses can act in unison instead of being overloaded to compensate for poor hearing. For seniors, and even for those over 50 who may have a faster progression of hearing loss due to prolonged technology use such as cell phones, earphones, etc., potential loss of balance makes it even more essential for people to be proactive in their approach to hearing loss. People who cannot hear well may stay by themselves and be less active. Reduced activity can put you at risk for falling, in and of itself. Hearing professionals urge those over 50 to get a baseline hearing screening and to make annual hearing screenings part of their health regimen.

Hearing loss is an invisible condition and it usually comes on slowly so many individuals are unaware of the extent of their hearing loss, may deny it if suspected, and often don’t report it on physical exam, nor do primary care physicians routinely test for hearing loss. But when hearing loss is corrected by the right hearing aid, the comments often reflect the level of unawareness of the problem before, and an appreciation for having the world open to them again.

The cost of falls.

One in three Americans over 65 years of age falls each year with 2.2 million people needing emergency room treatment, and over ½ million hospitalized. The estimated medical costs exceed $30 billion each year. Falls remain the leading cause of fatal and non-fatal injuries for older Americans, and a leading cause of disability. The average woman over 65 who breaks a hip is five times more likely to die within a year than a woman who doesn’t fall and break a hip. If proper hearing evaluation and correction could be addressed, the toll to individuals and families as well as the costs to the medical system can be significantly altered.

This story is part of an ongoing series between GoLocal and Beltone - a sponsored content series.