Impact of Hearing Loss Asymmetry on Odds of Falling

Introduction: Hearing loss is associated with an increased falls risk. Studies to date have focused on symmetric sensorineural hearing loss without consideration of asymmetric hearing. It has been hypothesized that changes in spatial cues may help to explain the association between hearing loss and falls. Given that those with asymmetric hearing may have poorer spatial hearing ability, we aimed to 1) examine the odds of falling in normal hearing, symmetric, and asymmetric hearing loss and 2) investigate whether the magnitude of asymmetry impacted the results.

Methods: Patient audiometric data and falls data from a tertiary care institution’s audiology clinic between 2013 and 2021 were retrospectively examined. Covariates including demographics, comorbidities, and falls-related medications were collected. Adult patients with either normal hearing or sensorineural hearing loss were included. Raw audiometric data were classified by severity and symmetry status. Logistic regression analyses were performed.

Results: A total of 12,785 patients met inclusion criteria. Individuals with normal hearing had lower odds of falling compared to those with symmetric hearing loss (OR (CI): 0.561 (0.483, 0.652), p< 0.0001) and no significant difference was appreciated between symmetric and asymmetric hearing loss groups (p=0.3898). In adjusted modeling, older individuals (OR (CI): 1.018 (1.014, 1.021), p< 0.0001) and females (OR (CI): 1.373 (1.238, 1.523), p< 0.0001) had higher odds of falling than their counterparts. Additionally, the magnitude of asymmetry was not significantly associated with falls status (p>0.05).

Conclusions: Our results suggest that older adults and females have a higher falls risk, irrespective of symmetry pattern or magnitude of asymmetry. This better informs patient counseling and prompts additional studies to examine proposed mediators between hearing loss and falls.