Why do we ignore a major risk factor for falls in the elderly?

A single easily correctable condition can increase the risk of falls in the elderly three-fold and often more. Why do we choose to ignore it?

In today’s New York Times (Nov 2), reporter Katie Hafner writes a fascinating article on the ways nursing homes and facilities for the elderly are rethinking the risk of falls in their patients and residents.

The article includes several very interesting photo/graphics showing how the elderly with impaired vision see, say, a flight of carpeted stairs, and then another showing how the addition of a simple contrasting stripe on the stair can make the stair far more visible. There’s also a photo of a black toilet seat. It seems weird and even possibly unsanitary, but it helps older people know exactly where to sit.

Contrasting toilet seats can help prevent falls in the elderly. So can bold markings on carpeted staircases. Good!

But why do we focus solely on visual aids and ignore the well-documented benefit of hearing aids? Even mild hearing loss results in a three-fold greater risk of falls in the elderly, and the numbers go up with age.

Yet here is another article about falls in the elderly with not a single reference to hearing loss.

I would say this is shocking, but I’m ever more resigned to the fact that hearing loss is ignored almost universally, even though it affects 20 percent of Americans of all ages, and more than two-thirds of Americans 75 and over.

And it has a marked documented affect on physical and mental health, verified in one study after another.

The physical consequences can be deadly. Falls are the leading cause of death in the elderly.

A 2012 study by the National Institute on Aging (Luigi Ferrucci) and Johns Hopkins University School of Medicine (Frank Lin) found a three-fold greater risk of falls in those over 65 who had even mild hearing loss.

A mild hearing loss is one characterized by a 25-decibel loss. For each addition decibel of loss, the risk increased the chances of falling 1.4 fold.

Hearing and balance are both regulated by the vestibular system, but Dr. Lin believes that a more pertinent explanation is that people who can’t hear well might have trouble being aware of their overall environment, making tripping and falls more likely.

Another explanation is that in people with even mild hearing loss, the brain has to work harder to process sound, reducing the cognitive resources available for processing things like gait and balance.

Eighty percent of 80-year-olds have hearing loss serious enough to warrant hearing aids. Exactly 15 percent of them have hearing aids. The numbers with hearing loss just go up as we age into the late 80’s and 90’s. But the incidence of hearing aid use doesn’t change much.

It’s essential that we begin to pay attention to the role of untreated hearing loss in the physical and mental health of the elderly. Black toilet seats are good, but hearing aids are even better.

2 thoughts on “Why do we ignore a major risk factor for falls in the elderly?

  1. Would the stripes be put on all the carpeted stairs or just the floor before the 1st step (or on the 1st step) & the floor after the last step (or on the last step)?
    What about single stripes (or dashes) on all steps & double stripes on the floor after the last step? This would be similar to the stripes & dashes on the roads that most people would remember. The single stripe (or dashes) would signify that that there are steps to pass & the double stripes would signify that there are no more steps to pass.
    I like the idea of a contrasting black (or color) toilet seat!

    Liked by 1 person

  2. Hearing loss is ignored as a factor because it’s invisible and people who write these articles have no way to experience it themselves. Consequently, they ignore it or don’t even consider it as a possible factor. It’s easy to simulate low vision. It’s easy to close your eyes and pretend you are blind. Not so, with hearing loss. When polled, the majority of the general population will tell you they would rather be deaf than blind. Hearing loss doesn’t maim nor kill, and all too often it is assumed that hearing loss is only an issue among the elderly. Organizations like The Hearing Loss of America have done a lot to share solid information on hearing loss. HLAA has also encouraged the research you mention in your blog. Prior to the founding of The National Institute for the Study of Deafness and other Communication Disorders (NIDCD), within the National Institutes of Health in 1988, (something that HLAA’s predecessor Self Help for Hard of Hearing People, Inc. campaigned vigorously for), very little research was focusing on partial deafness. Today we know this sensory disability affects 48 million Americans of all ages. Getting that info out to the public, and erasing the stigmas that still stick to definitions of people with hearing loss is a challenge. Thankfully, we are making progress. Blogs like this help, and many of us are writing them, yet we still touch only the tip of this iceberg! Anyone who wishes to jump on the bandwagon to effect change should join HLAA and let their voice be counted. http://www.hearingloss.org

    Julie M Olson
    Neenah Wisconsin

    Liked by 1 person

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