Background: Falls are a devastating condition in older individuals. Identifying potentially modifiable risk factors such as hearing loss would provide a substantial public health benefit. Objective: To evaluate the current evidence for an association between hearing loss and falls risk. Data Sources: A systematic search of PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Scopus, Web of Science, and Cochrane databases was performed in July 2014. Study Eligibility: Studies were eligible for inclusion if they were published in the peer-reviewed literature. All studies used a predetermined definition of hearing loss. Main outcomes and measurements were fall hospitalization records or self-reports of falls by structured interview or validated questionnaires. Study Appraisal and Synthesis: Two investigators independently reviewed the literature related to hearing loss, falls, and older adults. We pooled effect sizes from across the studies and performed a meta-analysis to compute an overall effect size. Results and Limitations: Twelve eligible studies were identified. The odds of falling were 2.39 times greater among older adults with hearing loss than older adults with normal hearing (pooled odds ratio 2.39, 95% confidence interval [CI]: 2.11-2.68). In sensitivity analyses, we restricted the meta-analysis to studies where hearing loss was audiometrically defined (N = 6) and observed hearing loss to be associated with a 69% increase in the odds of falling (pooled odds ratio 1.69, 95% CI: 1.18-2.19). When we further limited to studies that also performed multivariate regression analyses (N = 4), the overall effect size did not appreciably change (pooled odds ratio 1.72, 95% CI: 1.07-2.37). We observed a potential positive publication bias in the literature. Limitations of the systematic review and meta-analysis are the cross-sectional designs of most studies and the heterogeneity across studies (Q = 631, P <.05, I2 = 98.1%). Conclusions and Relevance: In the published literature, hearing loss is associated with a significantly increased odds of falling in older adults. These findings need to be interpreted in light of the potential for positive publication bias in the literature on this topic.
|Original language||English (US)|
|State||Accepted/In press - 2016|
- Hearing loss
- Older adults
- Risk factors
- Systematic review
ASJC Scopus subject areas