People with hearing loss worse at balancing and walking

Targeting the problem could slow down physical declines in ageing.

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Older adults with hearing loss have significantly worse physical function – including balance and walking endurance – than their peers with normal hearing, according to a population-based study of almost 3,000 US participants.

Previous studies have found that treating this condition may help protect the cognitive health of older patients. Now, this latest research suggests it may also help slow their physical decline, the authors said.

In the study, researchers assessed both the participants’ hearing and their balance, gait speed, endurance and chair stands at baseline and regularly over the next eight years.

The study found a statistically significant, dose-dependent relationship between hearing loss and physical function. For every reduction of 10 decibels in hearing, there was a comparable reduction in physical performance composite scores and walking speed.

“For example, per 10dB HL increase (hearing loss in decibels), mean physical function score was -0.17 points, and mean gait speed was -0.01m/s,” the authors wrote in JAMA Network Open.

From year five onward, those with mild to moderate hearing impairment lost 0.92 points per year compared to 0.50 points among those with normal hearing.

During the two-minute fast-paced walk test, those with moderate hearing loss walked almost three metres less than those with normal hearing, while patients with severe hearing loss walked 5.3 metres less.

However, there was no association between hearing impairment categories and chair stand test results.

“Because hearing impairment is amenable to prevention and management, it potentially serves as a target for interventions to slow physical decline with ageing,” the authors said.

Hearing impairment had previously been shown to increase the risk of neurocognitive disorders, but the association between hearing and walking endurance had been documented in only a few studies, the authors said. 

However, they did suggest that perhaps the physical decline could be more related to the associated cognitive decline, than the hearing loss itself.

“The association between hearing and physical function may be mediated through reduced cognitive resources, depression, social isolation and reduced life space, resulting in less physical activity,” they said.

It was time to investigate this link more fully, said the US authors of an associated commentary in JAMA.

“This and prior work raise the intriguing idea that hearing may provide essential information to the neural circuits underpinning movement in our environment and that correction for hearing loss may help promote physical wellbeing,” they said.  

While hearing loss remained an undertreated condition, they noted the study could not assess the clinical implications and impact on daily activities, which might be valuable when considering interventions.

“For example, if hearing loss is associated with poor physical functioning and falls, a broad multidimensional and interprofessional intervention, including hearing health care as well as physical therapy and activities such as tai chi or other balance training, may be most appropriate.”

JAMA Network Open 2021, 25 June