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Hearing loss and postural balance performance in adults and the elderly in ELSA-Brazil
Fernanda Yasmin Odila Maestri Miguel Padilha1, Vitor Martins Guesser1, Camila Maia Rabelo1
1Universidade de São Paulo. Faculdade de Medicina. Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional. São Paulo, SP, Brasil.
Objective:
To investigate the association between hearing loss and postural balance in adults and the elderly participating in the Estudo Longitudinal da Saúde do Adulto (ELSA-Brazil - Longitudinal Study of Adult Health).
Methods:
Cross-sectional study with data from the fourth wave (2020-2025) of ELSA-Brazil, in the center of São Paulo. Sociodemographic, clinical, and audiological variables were analyzed. Hearing loss was defined by the average of the tonal thresholds (> 25 dBHL) in different criteria: PTA (0.5 kHz-2kHz), speech-frequency PTA (0.5 kHz-4kHz), and high-frequency PTA (3 kHz-8kHz), considering the better and the worst hearing ear. Balance was assessed using the modified Romberg test, in four progressive conditions (eyes open on a firm surface, eyes closed on a firm surface, eyes open on a soft surface, and eyes closed on a soft surface), with a binary classification (pass/fail). The outcome was performance in the balance test.
Results:
A total of 540 participants were assessed, mostly women, self-declared white, mean age of 63.1 years, mean Body Mass Index (BMI) of 28.4 kg/m2, with higher education and income between R$ 1,245.00 and R$ 3,319.00. The rate of balance failure was 13.3%. The prevalence of hearing loss ranged from 13.7% to 59.8%, depending on the criteria used. There was an association between hearing loss and worse performance in the balance test, especially for high-frequency PTA. In the logistic regression models, there was a significant association between the explanatory variable age and failure in the balance test. After excluding the age variable, there was an association for hearing loss, BMI, schooling, and income.
Conclusion:
There was an association between hearing loss and poorer balance performance. The highest proportion of failures was for the hearing loss criterion that included high frequencies. Age was the most relevant explanatory variable in balance test performance, in addition to hearing loss, schooling, income, and BMI, emphasizing the need for a multifactorial view of this function.
