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01-03-2012 | Speech-language pathology | Article

Hearing loss ‘a robust risk factor for falls in older adults’

Abstract

Free abstract

MedWire News: Hearing loss is a newly discovered risk factor for falls in older adults, suggests research published in the Archives of Internal Medicine.

The study, which involved a nationally representative sample of US adults aged 40-69 years, found that people with hearing loss had an increased risk for falling, which rose in line with the severity of deafness.

The study is reported in a research letter by Frank Lin (Johns Hopkins School of Public Health, Baltimore, Maryland, USA) and Luigi Ferrucci (National Institute on Aging, Bethesda, Maryland, USA).

The researchers analyzed data on 2017 participants in the National Health and Nutrition Examination Survey, all of whom underwent audiometry to detect hearing loss.

A loss of greater than 25 dB (indicating any level of hearing impairment) was detected in 14.3% of the cohort, while 4.9% reported falling in the preceding 12 months.

In an unadjusted analysis, hearing loss was significantly associated with the odds of reported falls, with a 1.4-fold increase in risk for each 10-dB increase in hearing loss.

Adjusting for demographic factors (age, gender, race, education), cardiovascular factors (smoking, diabetes, hypertension, stroke), and vestibular balance function altered this association only marginally, giving an odds ratio of 1.6, report Lin and Ferrucci.

In a further analysis that was restricted to participants with hearing loss of 40 dB or less (indicating mild impairment), the odds ratio was similarly unaltered.

Discussing the results, Lin and Ferrucci say that their data are "robust" and support hearing loss as a previously unknown, clinically significant risk factor for falls in older adults.

They propose three potential explanations for the observed association. There may be a concomitant dysfunction of both the cochlear and the vestibular sense organs; decreased hearing sensitivity may directly limit access to auditory cues that are needed for environmental awareness; and finally, the association of hearing loss with falls may be mediated through cognitive load and reduced attentional resources.

"Attentional resources are critical for maintaining postural control, and decrements in attentional and cognitive resources imposed by hearing loss may impair the maintenance of postural balance in real-world situations and increase the risk of falling," they write.

The researchers conclude: "Further prospective research is needed to determine whether hearing loss is a modifiable risk factor for falls that may be amenable to hearing rehabilitative strategies that remain underused."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Joanna Lyford

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