Postural Balance, Hearing Loss, and Cognitive Executive Function in the Elderly: Are They Related?

Background: There might be a significant association between hearing loss (HL) and cognitive performance or postural imbalance, but how they relate to each other remains unknown. The aim of this study is to gain an understanding of these relationships. Methods: An observational prospective study with subjects ≥ 55 years old divided into groups: normal hearing (group A), untreated HL > 20 decibel hearing level (dBHL) (group B), and patients with treated HL > 20 dBHL (group C). At the initial visit and follow-up, participants underwent tests and questionnaires evaluating hearing, balance, and cognition. Statistical analyses-including relative risk, Spearman's Rho correlation, interaction, and adjusted models-were performed using Stata 17; a p-value < 0.05 was considered statistically significant. Results: In total, 714 subjects were initially recruited: 210 in group A, 302 in group B, and 202 in group C. A mean follow-up time of 3.6 years was completed by 101 individuals. Compared with the normal-hearing group, hearing loss increased the probability of unsteadiness by 1.4-fold in group B and 4.1-fold in group C. Poorer performance on the Timed Up and Go (TUG) test was predicted by lower scores on both cognitive executive function tests, with correlations of -0.4 and 0.34 (p < 0.001). Regarding confounding factors, statistically significant differences were found for age and education in cognitive performance; age in the TUG results; and sex, cardiovascular risk factors (CVRF), and education in HL. Conclusions: Postural imbalance and cognitive executive function are related to HL. However, there is no evidence linking dizziness to cognitive executive function, although an association with TUG results was found. Therefore, HL is correlated with both balance and cognition, and cognition is also related to balance.