Hearing Loss in the Elderly: Implications for Balance and Fall Risk (original) (raw)
Related papers
Hearing Loss Contributes to Balance Difficulties in both Younger and Older Adults
Journal of Preventive Medicine, 2018
Objective: The number of steps required to regain balance is an easily obtainable clinical outcome measure. This study assessed whether number of steps during loss of balance could identify older adults with hearing loss who have balance deficits. We aimed to answer two questions: 1) Does hearing loss negatively affect the ability to regain balance, as reflected by an increased number of steps needed to respond to a perturbation while simultaneously attending to speech-in-noise; and 2) Do hearing aids improve balance control, reflected by a decrease in number of steps needed to regain balance? Methods: 20 young adults and 20 older adults with normal hearing, and 19 older adults with hearing loss performed an auditory-balance dual-task. Participants were asked to listen and repeat back sentences from a standardized audiology test, while simultaneously responding to backward surface translations. Outcome measures were performed on the auditory test and number of steps needed to regain balance. Repeated measures ANCOVA models were run in using group, time, hearing levels, and perturbation levels as predictors. Results: Auditory scores confirmed difficulty hearing speech-in-noise in older adults with hearing loss and no hearing aids, and in young and older adults with normal hearing and simulated hearing loss. Results showed that group, auditory and balance conditions are significantly related to both outcomes measures and time is not significant for steps. Older adults with hearing loss had a significant increase in number of steps needed to regain balance compared to young adults and older adults with normal hearing. Conclusion: Number of steps may be an appropriate clinical assessment tool for identifying fall risk in older adults with hearing loss. Further research needs to be performed to identify proper assessments and treatment interventions for older adults with hearing loss who have balance deficits.
International Archives of Otorhinolaryngology, 2012
Summary Introduction: The aging process provokes structural modifications and functional to it greets, compromising the postural control and central processing. Studies have boarded the necessity to identify to the harmful factors of risk to aged the auditory health and security in stricken aged by auditory deficits and with alterations of balance. Objective: To evaluate the effect of auditory prosthesis in the quality of life, the balance and the fear of fall in aged with bilateral auditory loss. Method: Carried through clinical and experimental study with 56 aged ones with sensorineural auditory loss, submitted to the use of auditory prosthesis of individual sonorous amplification (AASI). The aged ones had answered to the questionnaires of quality of life Short Form Health Survey (SF-36), Falls Efficacy International Scale- (FES-I) and the test of Berg Balance Scale (BBS). After 4 months, the aged ones that they adapted to the use of the AASI had been reevaluated. Results: It had ...
Can hearing amplification improve presbyvestibulopathy and/or the risk-to-fall ?
European Archives of Oto-rhino-laryngology, 2020
Purpose The decline of sensory systems during aging has been widely investigated and several papers have correlated the visual, hearing and vestibular systems and the consequences of their functional degeneration. Hearing loss and presbyvestibulopathy have been found to be positively correlated as is with the risk-to-fall. Material and methods The present study was therefore designed as systematic review (due to PRISMA criteria) which should correlate hearing amplification by hearing aids and/or cochlear implants with balance outcome. However, the literature review (Cochrane, PubMed) revealed ten paper (prospective, controlled trials and acute trials) with heterogenous patient popiulations and non-uniform outcome measures (i.e., gait analysis, questionnaires, postural stabilometry) so that no quantitative, statistical analysis could be performed. Results The qualitative analysis oft he identified studies showed that hearing amplification in the elderly improves spatiotemporal orientation (particularly with cochlear implants) and that the process of utilizing auditory information for balance control takes some time (i.e., the neuroplasticity-based, learning processes), usually some months in cochlear implantees. Discussion Hearing and balance function degenerate independently from each other and large interindividual differences require a separate neurotological examination of each patient. However, hearing amplification is most helpful to improve postural stability, particularly in the elderly. Future research should focus on controlled, prospective clinical trials where a standardized test battery covering the audiological and neurotological profile of each elderly patient pre/post prescription of hearing aids and/or cochlear implantation should be followed up (for at least 1 year) so that also the balance improvements and the risk-to-fall can be reliably assessed (e.g., by mobile posturography and standardized questionnaires, e.g., the DHI).
Hearing as a Predictor of Falls and Postural Balance in Older Female Twins
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 2009
Background. The purpose of the present study was to examine, fi rst, whether hearing acuity predicts falls and whether the potential association is explained by postural balance and, second, to examine whether shared genetic or environmental effects underlie these associations.
Impact of Hearing Loss on Patient Falls in the Inpatient Setting
American Journal of Preventive Medicine, 2020
The objectives of this study were to investigate an association between the risk of patient falls and self-reported hearing loss and to examine whether self-reported hearing loss with versus without hearing aids predicts patient falls in an inpatient setting. Methods: This retrospective cohort analysis was conducted in 2018 in a large, urban, academic medical center. Participants included unique inpatients (N=52,805) of adults aged >18 years between February 1, 2017, and February 1, 2018. Outcome measures were falls in the inpatient setting and hearing loss with versus without hearing aids as predictors for patient falls. Results: Self-reported hearing loss was associated with falls in the inpatient setting (OR=1.74, 95% CI=1.46, 2.07, p<1.43 £ 10 À9). Among patients with hearing impairment, a lack of hearing aids increased the risk for falls in the inpatient setting (OR=2.70, 95% CI=1.64, 4.69, p<1.41 £ 10 À5). After accounting for the risk of fall using the Morse Fall Scale (which does not include hearing impairment) and controlling for age and sex, patients with hearing loss and no hearing aids were significantly more likely to fall (OR=2.44, 95% CI=1.002, 5.654, p<0.042), but patients with hearing loss who did have hearing aids were not significantly more likely to fall (p<0.889). Hearing loss together with the Morse Fall Scale better predicted falls than the Morse Fall Scale alone (p<0.017). Conclusions: In the inpatient setting, there was a positive association between hearing loss and falls. However, among patients with hearing loss, only those without hearing aids were significantly more likely to fall, accounting for the Morse Fall Scale score and demographics characteristics. These findings support adding hearing loss as a modifiable risk factor in risk assessment tools for falls and exploring the use of amplification devices as an intervention.
Folia Phoniatrica et Logopaedica
Introduction: Balance and postural control are related to hearing and hearing loss, but whether they can be improved with hearing aid use in older adults is not clear. We systematically reviewed controlled studies in which balance and hearing were tested in experienced older hearing aid users to determine the potential effects of hearing aid use on balance. Methods: The review was pre-registered in PROSPERO and performed in accordance with PRISMA. The question, inclusion, and exclusion criteria were defined using the Population, Intervention, Control, Outcomes and Study design (PICOS) framework. Older adults with hearing loss and no experience with hearing aids, or balance tests conducted without hearing aids in hearing aid users served as controls. Results: A total of 803 studies were screened, eight of which met the inclusion and exclusion criteria and were included in the final review. Five of the eight studies found a significant correlation between the use of hearing aids and t...
Evaluation of the relationship between osteoporosis, balance, fall risk, and audiological parameters
2019
The aim of the study is to investigate the factors such as balance and audiology parameters and bone mineral density (BMD), which were thought to be associated with the increased risk of fall in osteoporotic patients. Ninety-nine female patients between the ages of 40 and 75 were included in the study. Noise exposure, tinnitus, and vertigo were investigated. BMD measurement, Berg Balance Scale (BBS), Timed Up and Go (TUG), and stabilometry tests were applied to the patients. Patients were divided into three groups according to BMD measurements. Patients with a T score of − 1 and below were considered normal (control) (group 1), those with a T score of − 1 to − 2.5 were considered osteopenic (group 2), and those with a T score of − 2.5 and above were considered osteoporotic (OP) (group 3). BBS was 42.06 ± 5.00, 47.74 ± 5.18, and 51.65 ± 3.64 in groups1, 2, and 3, respectively. The difference between the groups was statistically significant (p = 0.001). OP patients had higher oscillation values in all measurements compared with the control group. However, the difference was statistically significant especially on mobile platforms (p < 0.05). Mean tones of pure tone thresholds at 500-8000 Hz for ears were significantly different in patients with OP compared with controls (p < 0.05 for 500-2000 Hz, p < 0.01 for 4000-8000 Hz). This study demonstrated that BMD reduction was correlated with balance parameters and audiological measurements. Therefore, it can be concluded that OP may affect the risk of fracture occurrence not only by decreasing BMD but also by increasing the risk of falling. Key Points • In the present study, the effects of balance and audiology parameter measurements on osteoporosis (OP) were investigated. In addition, the associations between vertigo, tinnitus, history of falling, body made index, vitamin D, and calcium values and osteoporosis were evaluated. • We determined that bone mineral density (BMD) reduction was related to balance and audiological parameters. It can be speculated that OP may affect the risk of fracture occurrence not only by decreasing BMD but also by increasing the risk of falling. We think that early diagnosis, appropriate treatment, and rehabilitation of hearing loss and OP may decrease the incidence of falling and improve the quality of life of the affected individuals.
Fall risk assessment and effect of vestibular rehabilitation in the elderly population
The Egyptian Journal of Otolaryngology
Background Accidental falls in elderly represent a major healthcare problem; they are a major cause of accidental death in people above 65 years of age. They result in both physical and psychological trauma, where fear of falling is a major consequence that leads to a vicious cycle that makes elderlies more isolated and dependent, making them more vulnerable to falls. Falls are multifactorial, where dizziness is a common factor in elderlies. Thus, a multi-systemic approach is essential for the assessment of balance functions; it also serves as a guide for treatment planning, either in the presence of a cause-specific pathology or when presbyvestibulopathy is the sole issue. Vestibular rehabilitation is useful in training elderlies to improve their dizziness and balance functions. Aim The aim of the study is to assess fall risk in elderly participants and to assess the role of customized vestibular rehabilitation in decreasing dizziness and falls in elderlies identified to be at risk...
Annals of Epidemiology, 2004
To determine if age-related hearing loss may be related to bone health. Decreased vestibular function has been associated with hearing loss, and osteoporosis may be a cause of such demineralization. We hypothesized that hearing loss would be related to an increased risk of falling and osteoporotic fracture in 6480 women aged 65 years or older enrolled in the Study of Osteoporotic Fractures. We further hypothesized that decreased bone mineral density would be associated with hearing loss. METHODS: Hearing sensitivity was ascertained via screening audiometry, and was classified as normal, mild loss, or significant loss. Incident non-spine fractures and falls were ascertained every 4 months for an average 6.7 years and 3 years, respectively. RESULTS: The age-adjusted annual fall rate did not differ significantly by hearing category, nor did the risk of incident fracture. Adjustment for confounding factors had no effect on our results. Ageand BMI-adjusted mean calcaneal bone mineral density (g/cm 2 ) was 0.380 in the normal hearing group, 0.375 in the mild loss group, and 0.371 in the significant loss group (p ϭ 0.02). There were no significant differences in total hip bone mineral density across hearing categories. CONCLUSIONS: Our results do not support the hypothesis that hearing loss is a risk factor for fracture or falls.
Frontiers in Neurology
Falls are the main contributor to both fatal and nonfatal injuries in elderly individuals as well as significant sources of morbidity and mortality, which are mostly induced by impaired balance control. The ability to keep balance is a remarkably complex process that allows for rapid and precise changes to prevent falls with multiple systems involved, such as musculoskeletal system, the central nervous system and sensory system. However, the exact pathogenesis of falls caused by balance disorders in the elderly has eluded researchers to date. In consideration of aging phenomenon aggravation and fall risks in the elderly, there is an urgent need to explore the pathogenesis and treatments of falls caused by balance disorders in the elderly. The present review discusses the epidemiology of falls in the elderly, potential pathogenic mechanisms underlying multiple systems involved in falls caused by balance disorders, including musculoskeletal system, the central nervous system and senso...