Hearing Loss and Fall Risk: What the Research Actually Shows
By Dr. Layne Garrett, Au.D., FAAA, ABAC, CH-TM, CDP (About | YouTube | Podcast | LinkedIn)
Date Published: April 13, 2026 at 3:30 PM MDT
Table of Contents
- Why Hearing Loss Gets Left Out of Fall Prevention
- Does Hearing Loss Cause Falls? Three Ways It Increases Your Risk
- Does Hearing Loss Increase Fall Risk? What the Research Shows
- Can Hearing Aids Reduce Fall Risk?
- When Hearing Aids Won’t Be Enough
- What This Means If You’re in Utah
- FAQ
Most fall prevention programs focus on the usual suspects: weak muscles, vision problems, slippery rugs, and medications that cause dizziness. Hearing loss rarely makes the list. That’s a problem — because the research says it should.
Quick Answer: Even mild hearing loss can nearly triple your risk of falling — and most fall prevention programs don’t account for it at all. Hearing loss increases fall risk through three pathways: cognitive overload, reduced spatial awareness, and inner ear vulnerability. Research across more than 5 million participants confirms the connection, and studies show that properly fitted hearing aids worn consistently can cut fall odds by roughly 50%. If you have untreated hearing loss and any concern about balance or stability, this is a risk factor you can actually do something about.
I also cover this topic in a video — [VIDEO LINK]watch it here[/VIDEO LINK] if that’s more your style.
Why Hearing Loss Gets Left Out of Fall Prevention
Falls are the leading cause of injury death for adults over 65, according to the CDC. Over 14 million older adults fall every year. The medical costs exceed $50 billion annually. Those are serious numbers.
And yet, most fall prevention programs don’t screen for hearing loss. Doctors rarely ask about it. Patients almost never connect the two on their own.
I’ve been treating hearing loss for more than 20 years at our clinics in Utah Valley, and this is one of the most frustrating gaps I see in elder care. A patient comes in for hearing aids, mentions they’ve had a few falls lately, and it’s the first time anyone has connected those two things for them. That happens more often than it should — in Utah and everywhere else.
To be direct: if fall risk isn’t part of the conversation when hearing loss is diagnosed, that’s incomplete care. It leaves patients without information they need to stay safe.
Does Hearing Loss Cause Falls? Three Ways It Increases Your Risk
The connection isn’t obvious until you understand what’s actually happening in the brain. Once you see it, it makes sense.
1. Cognitive Overload
Your brain has a limited amount of processing power. Hearing loss forces it to redirect more of that power toward decoding sound.
Think of it this way. Think about a noisy restaurant in Provo. Your brain is working hard just to piece together what the person across from you is saying. That cognitive effort has to come from somewhere. It comes at the expense of other tasks — including monitoring your body position and maintaining balance.
Researchers call this the cognitive load hypothesis. When the brain is overworked trying to process degraded sound, there are fewer mental resources available for gait and spatial awareness. I see this play out clinically every week. Patients describe feeling exhausted after social situations — not because they were physically active, but because their brain was working overtime just to hear. That fatigue affects everything.
When you’re splitting your attention between hearing and walking, balance suffers. That’s not speculation. That’s physiology.
2. Reduced Spatial Awareness
Here’s something most people don’t realize. Your hearing is constantly mapping your environment — even when you’re not aware of it. A large room sounds different from a small one. Footsteps approaching from behind register before you see them. Subtle audio cues help your brain track the space around you. Researchers call this echolocation, and humans do it naturally.
When hearing loss removes or muffles those cues, your brain is navigating with less information. Research has found that hearing impairment negatively affects spatial orientation, navigation, and the ability to judge position and distance. Patients sometimes describe feeling disoriented in crowded spaces or uncertain about their footing in unfamiliar environments. They often assume it’s age or maybe vertigo. But frequently, it traces back to missing auditory information about their surroundings.
3. Inner Ear Vulnerability
Your inner ear houses two systems in the same small space: the cochlea, which handles hearing, and the vestibular system, which handles balance.
Damage that affects one often affects the other. The same processes that damage the delicate hair cells responsible for hearing can also affect the structures that detect head movement and body position. Researchers have found that hearing loss and vestibular dysfunction frequently occur together — especially with age.
What’s important to understand is this: even when researchers controlled for vestibular problems in their studies, hearing loss still independently predicted fall risk. So it’s not just that people with hearing loss happen to also have balance disorders. The hearing loss itself — through the cognitive load and spatial awareness pathways — is contributing to falls on its own.
Schedule a free hearing evaluation at our clinics in American Fork or Spanish Fork — or call us at (385) 332-4325.
Does Hearing Loss Increase Fall Risk? What the Research Shows
This isn’t a small effect. It’s clinically significant.
The landmark study came from Johns Hopkins in 2012. Researchers Frank Lin and Luigi Ferrucci analyzed data from over 2,000 adults ages 40 to 69. They found that people with mild hearing loss — just 25 decibels — had nearly three times the odds of reporting a fall. Every additional 10 decibels of hearing loss increased fall odds by 1.4 times. The relationship is dose-dependent: more hearing loss, more fall risk.
That study was a starting point. Researchers have been building on it since.
What a 5-Million-Person Analysis Found
A comprehensive meta-analysis published in JAMA Otolaryngology — Head and Neck Surgery pooled results from 27 studies involving more than 5 million participants. It found that hearing loss was associated with 51% greater odds of falls in cross-sectional studies, and 17% greater risk in longitudinal studies that followed people over time. That association held even after researchers accounted for vision problems, vestibular issues, and other known fall risk factors.
Here’s what I find most significant about that finding. Researchers tried to explain away the connection. They controlled for other sensory problems. They looked at different age groups, different continents, different study designs. The association remained. That’s the kind of consistency you don’t dismiss.
Falls are a public health emergency. Hearing loss is a treatable condition. The overlap between those two facts deserves more attention than it currently gets.
If you’re in Utah Valley or anywhere along the Wasatch Front and you’ve had a recent fall, a hearing evaluation is a logical first step. The same is true if you’ve noticed you’re more cautious on uneven ground than you used to be. Not because hearing loss is definitely the cause. But because it’s a treatable risk factor, and ruling it out takes less than an hour.
Schedule a free hearing evaluation at our clinics in American Fork or Spanish Fork — or call us at (385) 332-4325.
Can Hearing Aids Reduce Fall Risk?
The research here is more nuanced — but the direction is clear.
A 2023 study in the Journal of the American Geriatrics Society looked at older adults with bilateral hearing loss and compared fall outcomes between hearing aid users and non-users. People who wore hearing aids had about 50% reduced odds of experiencing a fall. Those who wore them consistently — at least four hours per day — had up to 65% reduced odds.
Those are meaningful numbers. But I want to be honest about what this research can and can’t tell us.
Not every study on hearing aids and fall prevention shows the same effect. Some find benefit. Some don’t. The difference consistently comes down to two things: whether patients actually wear their hearing aids, and whether those aids were properly fitted to begin with.
What I See in Practice
The pattern I see in practice is this. Patients who get hearing aids and wear them consistently — all day, every day — report feeling more confident on their feet. They feel more aware of their environment. They’re less exhausted by the end of the day. Some mention they stopped tensing up when walking through busy places, because they can hear what’s around them again. That increased awareness and reduced mental fatigue matter for balance.
The patients who don’t see those benefits usually fall into one of two groups. Either they’re not wearing their aids consistently, or their aids weren’t properly programmed to their specific hearing loss pattern. Owning hearing aids is not the same as being helped by them.
This is why real ear measurement verification is non-negotiable in my practice. Without verification, even premium technology may not be providing the right amplification. In fall prevention, as in tinnitus care, guessing isn’t good enough.
When Hearing Aids Won’t Be Enough
Hearing loss is one piece of a larger fall risk picture. I want to be clear about when treating hearing loss alone won’t be sufficient.
Other interventions to add: If you have significant muscle weakness, poor balance in quiet spaces, or a fall history unrelated to hearing — hearing care alone won’t be enough. Strength training, physical therapy, and balance exercises should be part of the plan.
When vestibular evaluation is warranted: Dizziness, a spinning sensation, or difficulty walking on uneven ground or in low light — that’s vestibular territory, not hearing. A referral to a balance specialist may be appropriate.
Medication review matters too: Several common medications — including some blood pressure drugs and sedatives — increase fall risk independently. If you’re on multiple medications and experiencing falls, your physician needs to be part of that conversation.
Fall prevention programs add value: CDC’s STEADI initiative and community-based fall prevention programs offer exercises and environmental assessments that complement hearing treatment. These work best in combination, not as alternatives.
The most effective fall prevention addresses multiple risk factors at once. Hearing is one you can actually do something about.
What This Means If You’re in Utah
Fall prevention and hearing care don’t have to be two separate conversations with two separate providers. That’s true whether you’re in American Fork, Spanish Fork, Lehi, Springville, Provo, or Orem. And if you’re in South Salt Lake County — Sandy, Draper, South Jordan, or Bluffdale — we’re expanding into that area and will have a clinic nearby very soon. You don’t need to travel far, and you don’t need a referral to start.
At Timpanogos Hearing & Tinnitus, fall risk is part of how we approach every patient over 60 with untreated hearing loss. We ask about falls, dizziness, and fatigue in social settings. Those aren’t small talk — they’re clinical data.
If you also have concerns that go beyond hearing — vestibular problems, balance issues, dizziness — we coordinate with your primary care physician or refer to specialists as needed. Comprehensive care means the whole picture, not just the audiogram.
Over 20 years, the pattern I see most often: patients come in because they’re struggling to hear their grandchildren during Sunday dinner. Then, in conversation, it comes out that they’ve had two falls in the past year. They assumed the falls were just aging. Nobody had connected the dots. That connection is our job.
When You’re Ready to Explore Your Options
Schedule your free consultation — we’ll test your hearing, discuss your fall history if relevant, and give you a clear picture of what’s happening and what would help. Most patients tell us the clarity they get from that conversation is worth the appointment alone.
Or call us at (385) 332-4325 — speak with our team directly.
Want to do more research first? Visit our Learning Center for more evidence-based information on hearing loss and its broader effects on health.
FAQ
Can hearing loss really cause falls if my balance seems fine? Yes. Balance and fall risk are not the same thing. You can have normal vestibular function and still have elevated fall risk from hearing loss, because the cognitive load and spatial awareness pathways operate independently of your balance organs. Many patients with hearing loss-related fall risk don’t feel “off balance” — they’re just slower to respond to environmental hazards or more mentally fatigued than they realize.
How much hearing loss does it take to increase fall risk? Even mild hearing loss increases the risk. The Johns Hopkins research defined that threshold at 25 decibels — which is the boundary between normal hearing and mild loss. That’s not a dramatic degree of hearing difficulty. Many people at that level assume their hearing is fine. The risk increases as hearing loss gets worse, but it doesn’t require severe loss to be clinically meaningful.
Do I have to wear hearing aids all day for fall prevention benefits? The research suggests consistent use matters significantly. The JAGS study found stronger benefits among people who wore hearing aids at least four hours per day. That’s the minimum — not the ideal. Wearing them consistently throughout the day, across different environments, is what gives your brain the ongoing environmental information it needs to support balance and awareness.
What if I’ve had hearing aids for years but still feel unsteady? First, make sure your hearing aids are correctly programmed for your current hearing loss. Hearing changes over time, and aids that were properly fitted three years ago may not be providing appropriate amplification today. Second, unsteadiness that persists despite well-fitted hearing aids warrants vestibular evaluation — there may be inner ear balance dysfunction that needs separate assessment. Come in and let us look at the full picture.
Should my doctor know about the hearing-fall connection? Yes. Bring it up, especially if you’re seeing your physician for fall prevention. Ask whether hearing screening is part of their assessment. If it’s not, request it. Annual hearing evaluations should be part of routine preventive care after age 60, alongside vision checks and blood pressure monitoring. Your audiologist and your primary care physician should be in communication if you have both hearing loss and fall history.
About the Author
Dr. Layne Garrett, Au.D., FAAA, ABAC, CH-TM, CDP is a board-certified audiologist and founder of Timpanogos Hearing & Tinnitus, with clinic locations in northern Utah. Over 20 years, he has specialized in tinnitus management, helping thousands of patients. Timpanogos Hearing & Tinnitus has been recognized as Best of State in Auditory Services 14 times and operates as one of only 14 Lenire Preferred Providers in the United States. His practice emphasizes patient education over sales-driven care.
Links: About | YouTube | Podcast | LinkedIn
Reviewed/Edited by: Dr. Layne Garrett, Au.D., FAAA, ABAC, CH-TM, CDP Date: April 13, 2026
