Increased risk of frailty and falls in older persons with hearing loss

PURPOSE: Hearing loss is highly prevalent in older adults and linked to adverse physical outcomes. Frailty and falls are major geriatric syndromes, contributing to morbidity and loss of independence. However, how hearing loss, frailty, and falls are interrelated remains unclear. METHODS: Data from a nationally representative survey of 9,951 community-dwelling adults aged ≥ 65 years in Korea were analyzed. Hearing loss was defined by self-reported hearing difficulty. Frailty was assessed using the Korean version of the FRAIL scale (K-FRAIL). Falls were defined as at least one fall in the past year. Logistic regression models were used to examine associations between hearing loss, frailty, and falls. Mediation analysis was performed to assess whether frailty mediated the association between hearing loss and falls. RESULTS: Older adults with hearing loss had a higher prevalence of prefrailty, frailty, and falls than those with normal hearing. Hearing loss was independently associated with frailty (adjusted OR 2.26, 95% CI 1.77-2.88) and falls (adjusted OR 2.63, 95% CI 1.86-3.72), and both associations were dose-dependent. At comparable frailty levels, individuals with hearing loss consistently showed higher odds of falls than those with normal hearing. Mediation analysis indicated that frailty accounted for 21.1% of the association between hearing loss and falls, while hearing loss remained independently associated with falls after adjustment for frailty. CONCLUSION: Hearing loss is independently associated with frailty and falls in older adults, with frailty partially mediating this relationship. These findings underscore the importance of incorporating hearing assessment into comprehensive geriatric evaluations and fall-prevention strategies.