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Ear Exam

Hearing Loss Linked to Comorbidities

By Kory Castro, Hearing Instrument Specialist & Practice Owner at Beltone

Digital - October 2022
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Perhaps surprising to some, there are multiple comorbidities that relate to hearing loss, and the ears themselves. There are six major comorbidities that are typically associated with hearing loss (Isolation, falling and balance, depression, diabetes, cardiovascular disease, and dementia or cognitive decline). A highly prominent example among the general population is cognitive ability tied to auditory deprivation.


Among the healthy hearing population, sound travels from the ears to the brain via auditory pathways; adversely, when these pathways shrink or go unstimulated, areas of the brain can atrophy as a causal effect. According to Johns Hopkins University research, hearing-impaired participants in a decade long clinical study on the effects of aging were found to have lost up to a cubic centimeter of brain tissue, annually. “The study also gives some urgency to treating hearing loss rather than ignoring it,” (Frank Lin, M.D., Ph.D). In this vein, word discrimination and speech understanding can decay, correlated to how hearing loss develops over time. Further, reversal of this cognitive comorbidity is minimal via any auditory treatment.  


Additionally, the presence of falling is often linked to inner-ear disorders like vertigo; simply, hearing loss can create an imbalance (i.e. one ear hearing better than the other) making a person feel disoriented and lacking directionality. This in and of itself can cause falling.


Hearing Care Professionals see these comorbid conditions at a daily rate. It’s unfortunately a normal occurrence. Many patients, even those with only mild hearing loss, have speech discrimination problems that continue to degrade when that hearing loss goes untreated. This is the case, as when any muscle is atrophying in the body, it is hard to remedy it back to 100%, and the same is true for the brain. Hearing aids are a tool to help slow this degradation, but they cannot reverse brain tissue damage.


Falling is the leading cause of fatal and non-fatal injuries among the elderly. Among this patient group, it is another frequently seen comorbidity. As patients often come in with casts on or bruising after a fall, this comorbidity is obvious and recognizable from the onset. This is unlike cognitive brain decline, which is less apparent and obvious due to the slow progression and less visible reactive signs. Thus, cognitive decline’s gradual acceleration leads to additional danger due to the lack of recognition and appearance.

Another Johns Hopkins study, that included just over 2,000 patients, suggested hearing loss as a risk factor for falls. “Gait and balance are things most people take for granted, but they are actually very cognitively demanding… If hearing loss imposes a cognitive load, there may be fewer cognitive resources to help with maintaining balance and gait," (Frank Lin, M.D., Ph.D).


Chiefly, ears are how the brain interprets sound. People hear with their ears and understand with their brain. The longer hearing loss goes untreated, the more likely it is that a patient’s word discrimination, or speech understanding, will also decline. Word comprehension and how the ears pick up sound at different frequencies go hand-in-hand. This effects how the brain processes speech. For many people, hearing loss occurs only at certain frequencies. Hearing aid technology is designed to amplify sound at specific frequencies, so that all of the sound is presented at a more normal level. Word comprehension can be somewhat improved through sound amplification for patients with poor word discrimination, but in most cases once the damage is done it can become very difficult to regain functional hearing.


If sufferers don’t have hearing loss treated, it’ll become increasingly difficult to do so. Over time, the brain can forget how to process speech to the point that a person may be able to hear sound, but they are unable to recognize or discern words. The technology that Beltone utilizes in its hearing aids can clean up the sound easily, but the brain will just hear a garbled mess.


It takes people seven years on average from first recognizing hearing loss to getting it treated. 48 million Americans have some form of hearing loss, and only a small portion are treated. Once a person is 55-years old, it is recommended they should have a hearing test regardless of other factors. If they don’t have hearing loss at that time, the test results will serve as a baseline to compare to during future, subsequent tests.


About the Author: Kory Castro is Board-Certified Hearing Instrument Specialist and co-owner of Beltone clinics located throughout Arizona and part of the nation's largest network of hearing healthcare providers. He is also President of the Casmin Hearing Group. As a hearing healthcare service provider, Kory strongly believes in his role as a community resource. Mr. Castro’s mission is to enable the hearing impaired to develop their full potential to communicate effectively with others, through the integrity and excellence of the services his organizations provide.

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