Comorbidities

Research has long pointed to links between common comorbidities such as hearing loss and decreased brain functioning over time, but some of the statistics may surprise you:

• On average, seniors with hearing loss experience significantly reduced cognitive function 3.2 years before their normal-hearing counterparts.
• Hearing-impaired seniors experience thinking and memory recall issues 30 to 40 percent sooner than their normal-hearing counterparts.
• Older adults with a hearing loss may lose over a cubic centimeter of brain tissue annually beyond normal shrinkage.
• Those with hearing loss can be up to five times as likely to develop dementia, depending on the severity of their hearing impairment.

That ringing, humming, buzzing, or clicking sound in your ear or head that no one else seems to hear? These sounds could be tinnitus, a common condition affecting an estimated 8 to 25 percent of adults worldwide. It can touch people of all ages, however, and is typically symptomatic of other issues such as:

• Thyroid problems
• Noise exposure
• Earwax blockage
• Medication side effect
• Hearing loss

Your eyes and ears work together as a team.

Both help you perceive the world around you, with hearing even enhancing the sense of sight. They both also help you — in conjunction with your joints, muscles, and brain — stay balanced and steady on your feet.

In addition, research points to links between age-related vision and hearing impairment. One study found that even after accounting for age, the two conditions are associated and “have a cumulative effect on function and well-being, significantly affecting both physical and mental domains.”

Many people don’t realize that hearing impairment can lead to vestibular, or balance, problems, which can lead to falls. In fact, research has shown that falls are more common among those with hearing loss.

In one study of more than 2,000 adults ages 40 to 69:

• Patients with a mild hearing loss were nearly three times as likely to have reported a fall in the previous year.
• Every 10-decibel increase in hearing loss also meant a 1.4-fold increase in the odds of a fall the prior year.

Balance and equilibrium are controlled by the body’s vestibular system, involving parts of the brain, eyes, inner ear, and sensory systems, including skin, joints, and muscles. Keeping your hearing in the best shape possible can help reduce the risk of balance issues.

Cardiovascular disease – including heart disease and stroke – is a global public-health challenge that is the number one killer in the world, with 17.7 million deaths, according to the World Health Organization (WHO). Cardiovascular disease is also found to be linked to hearing loss.

Exactly how heart disease and hearing loss are connected isn’t yet conclusive in all cases, but researchers have found that:

• Hearing loss is more prevalent among those who have a history of circulatory disorders, such as cardiovascular disease, than among those who don’t.
• Cardiovascular disease can cause decreased hearing sensitivity by actually restricting blood flow to the structures of the inner ear. These structures require blood flow for nourishment.
• People with heart disease are 54 percent more likely to experience a hearing loss, according to one study — even more so if they’ve suffered a heart attack.

Some risk factors such as age, gender, and family history can’t be helped, but, “..healthy choices such as avoiding tobacco, choosing a healthy diet, exercising regularly, and getting regular checkups can make a difference in helping prevent either condition.”

Both hypertension and hearing loss affect millions of people and can take a toll on quality of life, but keeping your blood pressure down could help keep your hearing up.

One study of more than 270 men and women ages 45 to 64, found a strong relationship between high blood pressure and age-related hearing impairment, with hypertensive patients having a greater degree of hearing loss.

The study didn’t pinpoint the causal link between the two conditions but suggested that hypertension may damage inner-ear blood vessels, accelerating age-related hearing loss.

Eating a balanced diet, staying active, keeping stress in check, maintaining a normal blood pressure, and addressing hearing problems early can make a huge difference in taking care of your circulatory system and your hearing health.

Smoking, the most preventable cause of death in the U.S. and Canada and the culprit behind most lung cancer cases, can also increase the chances of developing a hearing impairment — even without exposure to occupational noise.

With tobacco linked to various health conditions ranging from certain cancers, coronary heart disease, disease, stroke, emphysema, to chronic bronchitis and other serious conditions, it’s no wonder the list of reasons to quit smoking continues to grow.

Those who smoke are at greater risk of hearing loss than nonsmokers. The best defense: Reduce or eliminate tobacco use altogether.

It’s no secret that obesity, which affects some 650 million-plus adults and an estimated 380 million-plus young people up to age 19 — can raise the risk of stroke, heart disease, diabetes, and other serious health problems, but it’s also potentially linked to hearing impairment.

Scientists are still exploring possible cause-effect relationships between the two conditions, but theories include the stress that excess weight can inflict on the circulatory system, which then impacts the auditory system.

One study published in 2016, showed hearing loss to be more common among two groups at opposite ends of the weight spectrum — those categorized as underweight and those considered severely obese. Prevalence among the normal-weight, overweight, and obese groups wasn’t quite as pronounced.

Hearing loss is twice as common among people living with type 1 and type 2 diabetes, a chronic metabolic disease that isn’t yet curable but can be managed.

Much like presbycusis, or age-related hearing loss, diabetes related hearing issues commonly take a toll on higher-frequency hearing. This can potentially affect the ability to understand speech in noisy settings such as restaurants and parties.

Diabetes-associated hearing loss could affect one or both ears, may occur suddenly or gradually, and could appear with or without balance problems, but routine but routine hearing checks can help catch potential issues early.

As evidence of links between these two conditions grows, it’s recommended that annual hearing evaluations be a standard for individuals with either type of diabetes.

Osteoporosis — a potentially debilitating disease that affects bone health of those primarily in their 50s and 60s — may nearly double the risk of sudden sensorineural hearing loss (SSHL), according to researchers.

Science hasn’t yet concluded that osteoporosis actually causes SSHL, but studies have long indicated a connection between the two. More recently, researchers in Taiwan who published an investigation in 2015, found that:

• Those with osteoporosis had a 1.76-fold risk of experiencing sudden sensorineural hearing loss.
• Patients at seemingly greatest risk were adults 50 and older, women, and, possibly, those with hypertension and osteoporosis.

A causal relationship between the two conditions might not yet be conclusive, but there’s no doubt that taking good care of your bones and ears — for example, avoiding tobacco, exercising regularly, maintaining an appropriate weight, and eating healthfully — can help curb your risks.

Medications and other chemicals, such as some chemotherapy drugs, can damage the inner ear. It’s called ototoxicity, which can lead to hearing loss, tinnitus, and balance disorders. So far, more than 750 types of chemicals are suspected ototoxicants.

There are too many potential ototoxicants to name here, but agencies such as the U.S. Occupational Safety and Health Administration group them into five categories:

• Pharmaceuticals, such as loop diuretics, selected analgesics, some chemotherapy medications, and certain antibiotics
• Solvents, such as toluene, ethylbenzene, and trichloroethylene
• Asphyxiants, such as carbon monoxide, hydrogen cyanide, and tobacco smoke
• Nitriles, such as 3-butenenitrile, cis-2-pentenenitrile, and acrylonitrile
• Metals and compounds, such as mercury compounds, germanium dioxide, and lead

Avoiding the chemical source can help, but isn’t always possible, so check with your provider when taking medications. Get a hearing evaluation before taking ototoxic medications to monitor any possible changes in hearing or balance throughout your treatment. And contact your provider if you start to have any new symptoms such as tinnitus, hearing loss, or loss of balance.