Medical conditions
Hearing loss and falls
Hearing and balance share the inner ear, and research links hearing loss to falling. Here is why the two are connected, and what can be done about it.
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The connection
The balance and hearing connection
Hearing and balance are interconnected. The cochlea, which handles hearing, and the vestibular system, which senses movement and position, sit together in the inner ear and share the same fluid, blood supply and nerve pathway. Conditions that damage one often affect the other, which is why some causes of hearing loss are accompanied by dizziness or unsteadiness.
There is a second connection, unrelated to the inner ear. Sound tells you where you are. Footsteps, traffic, a door opening, the echo of a room all feed the brain's picture of the space around you. When hearing fades, that picture is thinner, and keeping steady takes more attention. Add the extra mental effort of listening, and there is simply less capacity left for the constant small adjustments that keep you upright. Researchers describe this as the brain's balance and attention budgets being spent on hearing. A widely cited Johns Hopkins study found that even a mild hearing loss roughly triples the risk of falling, and that the risk rises with the degree of loss.
Risk
Who is most at risk
Anyone with hearing loss has some increase in fall risk, but the combination of factors matters most. Pay particular attention if you or someone close to you has hearing loss and:
- Is over 65
- Has already had a fall, or a near miss
- Has dizziness, vertigo or a feeling of unsteadiness
- Takes several medications, especially for blood pressure, sleep or mood
- Has reduced vision
- Has diabetes, neuropathy or weakness in the legs
- Lives alone or is often alone
What to watch for
Warning signs
- Feeling unsteady in the dark or on uneven ground
- Reaching for walls or furniture when walking
- Dizziness when standing or turning the head
- Being startled by people or vehicles that "came out of nowhere"
- Difficulty walking and talking at the same time
A sudden change in hearing
A sudden change in hearing together with dizziness, which needs a physician the same day
Treatment
How treating hearing loss fits in
Hearing loss is one risk factor for falls that can be addressed directly, and addressing it has everyday benefits as well: hearing the grandchildren behind you on the stairs, the car in the parking lot, the kettle in the next room. Restoring sound with hearing aids gives the brain back part of its picture of the surroundings and reduces the effort spent on listening. Some studies have found that people who use hearing aids report fewer falls than those with untreated loss, though the research is still developing. Hearing aids are one part of a wider approach that includes strength and balance exercise, vision checks, medication review and a safer home.
At Hear & Co, we test hearing, remove wax, and fit and adjust hearing aids. If your hearing test or your symptoms suggest a balance problem, we will say so and recommend you see your physician, who can refer for a balance assessment.
Good to know
Questions about hearing and balance
Can hearing loss cause dizziness?
Hearing loss itself does not usually cause dizziness, but many conditions of the inner ear affect both hearing and balance, so the two often appear together. Dizziness with a change in hearing should be assessed by a physician.
Can ear wax affect balance?
A large wax blockage can cause a feeling of fullness and, in some people, mild unsteadiness. Removing it usually resolves both.
Do hearing aids help with balance?
They do not treat the balance system directly. They restore the sound cues that help you sense your surroundings and reduce listening effort, and some research finds fewer reported falls among hearing aid users. They work best alongside exercise, vision care and a medication review.
Should I have my hearing tested after a fall?
It is a reasonable step, especially if you are over 65 and have not had a test in the past two years. Hearing loss is easy to check and, if found, easy to address.
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