Self-Reported Hearing Loss and Nonfatal Fall-Related Injury in a Nationally Representative Sample

Abstract

Background/objective: To evaluate the relationship between self-reported hearing loss and nonfatal fall-related injury in a nationally representative sample of community-dwelling adults living in the United States.

Design: Cross-sectional analysis of national survey data.

Setting: National Health Interview Survey (2016).

Participants: A total of 30 994 community-dwelling adults in the United States, aged 18 years and older.

Measurements: We evaluated the association between self-reported hearing loss and nonfatal injury resulting from a fall in the previous 3 months. We used multivariate logistic regression to calculate adjusted odds ratios (ORs) and evaluated effect measure modification by age.

Results: The odds of nonfatal fall-related injury were 1.60 times higher among respondents with hearing loss compared to respondents without hearing loss (95% confidence interval [CI] = 1.20-2.12; P = .0012). Results were unchanged when adjusting for demographics (OR = 1.59; 95% CI = 1.18-2.15; P = .002). After adjustment for cardiovascular risk factors, cardiovascular disease, visual impairment, and limitation caused by nervous system/sensory organ conditions and depression, anxiety, or another emotional problem, the OR fell to 1.27 (95% CI = 0.92-1.74; P = .14). In the fully adjusted model, including adjustment for vestibular vertigo, there was little support to link hearing loss and fall-related injury (OR = 1.16; 95% CI = 0.84-1.60; P = .36). Effect modification by age was not observed.

Conclusions: Self-reported hearing loss may be a clinically useful indicator of increased fall risk, but treatment for hearing loss is unlikely to mitigate this risk, given that there is no independent association between self-reported hearing loss and nonfatal falls after accounting for vestibular function and other potential confounders.

Keywords: fall-related injury; falls; hearing loss; vestibular function.