Untreated Hearing Loss Increases the Risk of Imbalance and Falls: What the Science Says

Falls are a major public health concern, especially for older adults. According to a large systematic review and meta-analysis of more than 5 million participants, individuals with hearing loss had a 51% greater odds of falling compared with those without hearing impairment. Over time, hearing loss was also associated with a 17% greater longitudinal risk of future falls—meaning that even after adjusting for other factors, people with hearing loss had a significantly higher chance of falling again in the future. (JAMA Network)

Other studies support these findings: older adults with uncorrected hearing impairment may have between 1.5 and 2.4 times the odds of experiencing a fall compared with peers with normal hearing. (PubMed) These elevated likelihoods are not trivial—falls often lead to fractures, hospitalizations, loss of independence, and even increased mortality.

The good news is that hearing aids can mitigate this problem!

How Does Hearing Affect Balance and Fall Risk?

It might seem surprising at first that hearing—not just vision or leg strength—could affect balance. However, multiple mechanisms help explain the connection:

1. Hearing as a Sensory Anchor

Balance depends on integrated sensory information from vision, touch, proprioception (body position), and the inner ear. Sound cues provide spatial orientation and environmental awareness that support postural control. When hearing is diminished, the brain loses one of these critical sensory inputs, making balance more challenging.

2. Cognitive Load and Dual-Task Interference

People with hearing loss often expend extra cognitive energy just to understand speech and sounds. This increased cognitive load can steal mental resources away from maintaining steady gait and equilibrium, particularly in difficult environments (e.g., navigating uneven sidewalks or busy places).

3. Interaction With Vestibular and Musculoskeletal Function

Although hearing and balance originate from different parts of the inner ear, they share close anatomical and neurological pathways. In some cases, age-related degeneration can affect both hearing and balance systems simultaneously, compounding fall risk. (PubMed)

Key Research Findings

Elevated Odds of Falling

Systematic evidence: A meta-analysis of 27 studies showed that hearing loss was associated with 51% higher odds of falling cross-sectionally and a 17% greater longitudinal risk compared to normal hearing adults. (JAMA Network)
Population data: A Chinese longitudinal study reported that adults with hearing impairment had about 1.5 times the odds of falls compared with those without hearing loss. (PubMed)
Hearing aid survey: Community older adults with hearing loss reported about 2.4-fold higher fall risk compared with normal hearing peers. (PubMed)

Progression Over Time

One prospective analysis from the Health ABC study found that older adults with moderate-to-severe hearing impairment showed a faster annual increase in odds of falling over time than those with normal hearing. (PubMed)

Inpatient and Clinical Settings

In hospital patients, self-reported hearing loss was linked with a 74% increased odds of falling, and those without hearing aids were substantially more likely to fall than those who used them. (PubMed)

Why These Statistics Matter

Falls are not just numbers; for older adults, they can trigger a cascade of health events—fractures, reduced mobility, social isolation, and even increased mortality. Because hearing loss is so common (especially in adults over 65), it represents a substantial and modifiable risk factor for falls that often goes overlooked.

Importantly, research suggests hearing interventions like hearing aids may reduce fall prevalence and risk among people with hearing impairment, particularly when used consistently. (PubMed)

Conclusion

Uncorrected hearing loss significantly increases the likelihood of imbalance and falls. People with hearing impairment face substantially higher odds of falling—sometimes more than double—compared with those with normal hearing. Understanding hearing status as part of a holistic fall risk assessment can help clinicians, caregivers, and individuals take steps to reduce the risk of falls and their serious consequences.

References

Hearing loss and risk of falls: systematic review and meta-analysis showing increased odds of falls. PubMed PMID: 27010669 (PubMed)
Hearing impairment and falls in older adults (Chinese longitudinal survey). PubMed PMID: 35914491 (PubMed)
Moderate hearing impairment and increasing odds of falling over time. PubMed PMID: 26438083 (PubMed)
Hearing loss risk and fall prevalence with hearing aid use. PubMed PMID: 37314100 (PubMed)
Hearing loss and inpatient falls risk. PubMed PMID: 32444002 (PubMed)

January 20, 2026