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Hearing Loss and Falls

Dr. Danielle Tate, PT, DPT

September is my favorite month of the year! Although the dates and the campaigns vary, there is a lot going on to raise awareness for Fall Prevention and Balance Awareness. The National Council on Aging celebrates Fall Prevention Awareness Day on the first day of fall: September 22nd, 2017. First day of fall... clever, right? The Vestibular Disorders Association is celebrating its 20th year of Balance Awareness Week from September 18th-24th, 2017. There are also numerous local programs in various settings to help raise awareness and draw attention to the importance of improving balance and preventing falls, including the event I am involved with: Fight The Fall Community Open House at FYZICAL Therapy & Balance Center of Rockville.

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Many people may not understand how much of an impact hearing loss can have on your quality of life and safety. Lisa Packer, a writer for Healthy Hearing, wrote an interesting article in 2015: New research links hearing loss to an increased risk of falls. Here's a quick summary:

  • "A study by Dr. Frank Lin from the Johns Hopkins School of Medicine and Luiggi Ferrucci from NIOA (Hearing Loss and Falls Among Older Adults in the United States):(1)
    •  2017 people between the ages of 40 and 69 were assessed with regard to both hearing and vestibular function(1)
    •  14.3 percent of the participants had hearing loss greater than 25 decibels; and 4.9 percent of those studied reported falling at least once in the past year.(1)
    • Even a mild degree of hearing loss tripled the risk of an accidental fall, with the risk increasing by 140 percent for every additional 10 decibels of hearing loss.(1)
  • there are a few reasons that hearing loss is associated with an increased risk of falls: (2)
    • People with hearing loss have less environmental awareness to people, pets or other things going on around them. 
    • Decreased spatial awareness, i.e. where the body is positioned in relation to other people and objects around it, could be another reason for increased falls. 
    • cognitive overload (using more of their mental resources to hear and interpret speech and other sounds)  can be a hindrance to balance
  • Hearing aids make a significant difference in balance: in one study during the heel to toe test, participants with their hearing aids turned on were able to maintain balance for twice as long as when their hearing aids were turned off. (2)
  • Hearing aids help with staying alert AND balanced.  Dr. Timothy Huller, professor of Otolaryngology at the School of Medicine referred to a study: “The participants appeared to be using the sound information coming through their hearing aids as auditory reference points or landmarks to help maintain balance. It’s a bit like using your eyes to tell where you are in space. If we turn out the lights, people sway a little bit, more than they would if they could see. This study suggests that opening your ears also gives you information about balance.” (2)

During Physical Therapy Vestibular Evaluations, I've found it useful to include a simple "hearing screen" with an OtoSimple Hand Held Hearing Screener if my patient has not already had their hearing checked. It is a tool that plays different tones at 4 different frequencies. The screen is simply pass/fail, and is not used for diagnostic purposes. If the patient fails to hear even one of the tones, I stress to them that they should have their hearing checked. This opens the door to a discussion about how even mild hearing loss may impact their lives and how it is connected to balance. Patient's who are hesitant or uninterested at first usually walk away from the discussion with a different or modified point of view, and have been more likely to see an ENT or audiologist for an audiogram and/or hearing aids.


  1. Lin FR, Ferrucci L. Hearing Loss and Falls Among Older Adults in the United States. Arch Intern Med.2012;172(4):369–371. doi:10.1001/archinternmed.2011.728
  2. Packer, Lisa. “Hearing Loss and Falls Among Older Adults in the United States.” Healthy Hearing,, 8 Oct. 2015,

Reprinted with permission. Copyright Healthy Hearing (