Hi, I’m Dr. Eric Cobb from Z-Health Performance and today we’re going to talk about loss of hearing and fall risk. Now, if you are new to Z-Health, we are a brain-based education company. Our focus is on working with doctors, therapists, and coaches around the world; so if you find this information interesting and helpful, make sure to subscribe to the channel and also check out all of our free resources.
In my last video, we talked about a growing understanding that loss of hearing is associated with developing dementia and worsening of dementia as people age. We discuss some of the rationales around that. So today what I want to focus on is, how does hearing loss potentially impact us in other ways?
From a research perspective, one of the things that we are most concerned about now is that loss of hearing is clearly associated with an increased risk of falling. Now most people go, “okay, well falling’s not that big a deal.” Well actually it is when you look at the statistics regardless of the age group. Falls typically ranked somewhere from number one to number five in causes of injury and also death around the world so falling is kind of a big deal! So in our program we do a lot of work with the visual system, the vestibular system and movement systems in the body to try to not only make people stronger and faster and get them out of pain; but also to prevent falling because like I said it’s a big deal! So whenever we look then into the research around hearing loss and falling, it’s very clear at this point that with every kind of 10-decibel loss of hearing competency our fall risk goes up. So, by the time people have kind of a moderate amount of hearing loss the risk of falling triples over any kind of given period of time and in fact, whenever we look at hearing loss and hospitalizations; hearing loss over a 10-year period is associated with a 47 percent increase in showing up in the hospital. For some reason, whether that’s a fall or something else going on in the body, we talk a lot about from a brain-based perspective loss of sensation or loss of sensory competency anywhere in the body typically will eventually impact us significantly over time and that’s what we see with hearing loss. Ao the question, is why would hearing loss create a higher risk of falling?
Two primary theories, right now we’re still trying to tease all this out, but the basic idea number one is that if we don’t hear as well we are not as aware of what’s going on in our environment. So if we’re not sure of what’s happening, we don’t hear a warning sound, we may be more likely to fall on something, trip on something, and that’s kind of an obvious idea. If I can’t hear well, the environment becomes more dangerous. Now secondly, and kind of more from a brain perspective, another thing that people have to understand is that basic human functions like walking and standing are not really that basic. In fact, they are highly demanding tasks. They require a lot of different areas of the brain to be functioning well, so whenever we are experiencing hearing loss what will typically happen is that the brain will need to devote more energy to processing the information that’s coming in via the auditory system; understanding it and then trying to integrate it with other areas of the body which makes it a more cognitively demanding task. So researchers will basically say that loss of hearing increases cognitive load and we know from a variety of other arenas that as we increase cognitive load, we see changes in gait (how people walk) and we also see loss of balance control and balance competency. So hearing loss again, kind of a big deal!
We’ve talked about its association with dementia and now we’re talking about how it increases your risk of following falling, being injured and also winding up in the hospital. So the question, usually as I said that I always get is, what do I do about that? I’m a physical therapist or I’m a movement coach, how do I address this?
Well you address it via education. You talk to your clients about it and say look, use an online app use a smartphone app test your hearing. if there’s some significant differences right side vs left side or you have any concerns at all, get in to see a hearing professional. See an audiologist. Have an appropriate test done. I’m a big believer that as we deal with brain issues we need a short term and long term and one of the biggest things or best things that you can do for yourself as we look at kind of long-term issues that may develop from noise exposure in the environment from brain injuries, etc is to make sure that our hearing is as strong and as functional as possible. So if you do not get regular hearing tests, at some point it’s something you want to consider particularly if you’re noticing that you’re having more and more challenges with balance.
Last thing I want to bring up right now, because the next question always comes up is, do hearing aids then improve balance or are there other things that we can do to impact this risk of falling? Right now, the research from the last three or four years is mixed. There are a few studies that show that hearing aids do improve balance maybe between 13 and 19 percent for people that are already experiencing hearing loss. and there then there are some other studies that say we don’t really find that hearing aids have a huge impact on this. So right now, we don’t know for sure. Obviously there’s probably some inter-individual differences that are going to play a role in that it is worth testing, however now what else can we do? Well, there are a lot of other things that we can do the visual system the auditory system and the vestibular system (which controls balance) are all deeply linked so one of the things that we regularly recommend and work with our clients is if we are concerned about hearing loss, we not only make that appropriate referral, we also try to get very busy working on other systems looking at how the eyes are functioning and also doing a lot of vestibular training. Because the vestibular system is going to be critical for us in maintaining balance.
So from a broad perspective things that we know are balance exercises vestibular rehabilitation movement practices like Tai Chi. Tai Chi’s probably been one of the most studied just kind of basic exercise forms available to improve balance. Those are all fantastic practices as well as strength training. Strength training can make a big difference again as a tool to make sure that we are able to stabilize ourselves against sudden, you know bumps in the environment. We wanted to make sure that again, we got this out there.
Hopefully you found this interesting and helpful and if you have any questions let us know in the comments. Thanks!