Dizziness and imbalance: addressing hearing loss in falls prevention

Taran Tatla

Honorary Secretary, ENT UK

World Hearing Day highlights the need for greater awareness among healthcare professionals and the public of the impact of ear, nose and throat conditions on quality of life.

According to the World Health Organization, falls are the second leading cause of unintentional injury-related deaths worldwide and adults aged over 65 suffer the greatest number of fatal falls. The personal impact from non-fatal falls (fractured hips, head injuries, etc.) is large, while the health, rehabilitation and social care costs for an ageing population are debilitating.

Risk factors for falls

Fall-related risks often involve multiple factors, including age, occupation, socio-economic disadvantage, unsafe environments, alcohol or substance abuse and underlying medical conditions. Dizziness and imbalance are often side-effects of medications and drug interactions, especially in elderly people taking multiple medications.

Hidden audio-vestibular risk factors

Learning disability and cognitive or visual decline all have an impact too but hearing loss and ear disease have remained neglected in fall prevention strategies. The absence of published research has meant that even multi-faceted falls-prevention programmes have not been comprehensive when audio-vestibular diseases (diseases affecting hearing and balance) are not screened for and corrected in high-risk patients.

Hearing loss is common as we age. It is often easily corrected with simple earwax removal or hearing aid provision. The vestibular apparatus is a balance sensory organ in the inner ear linked with the hearing sensory organ (cochlea). Symptoms of dizziness, imbalance and tinnitus frequently accompany hearing loss.

Hearing loss is common as we age. It is often easily corrected with simple earwax removal or hearing aid provision.

Community screening and digital healthcare

Access to hospital-based ENT and audiology services during the pandemic has been restricted and waiting lists have grown. However, hidden age-related hearing loss is now increasingly recognised and addressed through high street screening initiatives, as well as mobile audiology units serving local communities.

Home-based hearing and balance screening has emerged for patients and their carers from innovative digital applications on computers, tablets and smartphones. Wearable devices such as smartwatches with accelerometers and sensors permit remote monitoring of high-risk falls patients. Monitoring includes heart rate, rhythm and oxygen levels, as well as patterns of physical activity, postural balance and falls.

Educational resources are available

Innovations and technological advances of this kind, along with research conducted in the medical sector and guidance published by charities and expert bodies such as ENT UK, can all play a valuable role in improving patient outcomes around conditions such as audio-vestibular-related dizziness and falls.