Does Hearing Loss Cause Falls?

By Simon Peter Lokomo, MPH — Public Health
Last reviewed: July 2026

Probably it contributes, but nobody has proven it. People with hearing loss do fall more often, and that pattern holds across millions of people. Whether the hearing loss is causing the falls is a harder question. In 2025 a trial found that giving people hearing aids cut their falls by about a quarter over three years, which is the best evidence available. It also needs confirming, for reasons worth understanding.

This is not a connection most families think about. You notice a parent turning the television up, or asking you to repeat things, and you file it under irritating rather than dangerous. I wrote this because the research on hearing and falling has moved quickly in the past two years, and because the honest version of it is more interesting than the headline version.

Do people with hearing loss actually fall more?

Yes, and the finding is consistent. A 2025 review in a leading ear, nose and throat journal pooled data on more than five million people. It found that at any given moment, people with hearing loss had about 51% higher odds of having fallen than people without it. That is a real and repeatable association.

But the same review reported a second number that matters more, and gets quoted far less. When researchers followed people forward over time rather than taking a snapshot, the increase in fall risk was much smaller: about 17%, with a confidence interval running from 6% to 29%. Following people forward is the stronger design for questions about cause, and it produced the weaker result.

There is a longer pattern here too. An earlier review in 2016 reported that people with hearing loss had 2.39 times the odds of falling. But when its authors narrowed to studies that measured hearing properly with an actual hearing test, rather than asking people, the figure dropped to 1.69. They also noted signs of publication bias, meaning studies finding a link may have been more likely to get published. By 2025, with better methods, the estimate had settled around 1.51.

An effect that shrinks each time somebody measures it more carefully is not necessarily fake. But it is a signal to hold the number loosely.

Does hearing loss cause the falls, or just travel with them?

Nobody knows, and there are good reasons for doubt. Hearing loss arrives alongside a great deal else: age, frailty, diabetes, cognitive decline, and reduced activity. All of those independently raise fall risk. Untangling hearing from its companions is genuinely difficult, and an observational study cannot do it fully.

There is also an anatomical complication that deserves more attention than it gets. The organ that detects sound and the organ that controls balance sit next to each other in the inner ear and share a nerve. Damage in that region can affect both. So a person with hearing loss may have balance problems arising from the same underlying cause, rather than because of the hearing loss itself. Hearing loss would then be a marker of the real problem, not the cause of it.

That said, there are plausible ways hearing loss could genuinely contribute. Sound gives you information about your surroundings: where the dog is, that someone is approaching from behind. Straining to hear also uses mental effort, and attention spent on listening is attention not spent on walking, which matters more than it sounds when someone is already unsteady. Both mechanisms are reasonable. Neither has been demonstrated to explain falls.

Do hearing aids reduce falls?

One trial suggests they might. The ACHIEVE study followed 977 adults aged 70 to 84 with untreated hearing loss for three years. Half got hearing aids plus counseling from an audiologist. Half got health education classes instead. The hearing aid group reported about 27% fewer falls over three years, an average of 1.45 falls per person against 1.98 in the comparison group.

That is a genuinely encouraging result, and it is the first randomized evidence on this question. Everything before it was observational. It is also the reason this article exists, because a randomized trial can do something no amount of population data can: it can separate the effect of treating hearing loss from all the things that travel alongside hearing loss.

Why that 27% needs handling carefully

Four things about how that trial was built should travel with the number every time you see it quoted. None of them means the result is wrong. All of them mean it is not yet the final word, and the researchers who ran the study are clear about this themselves.

One more thing worth stating plainly, because this site’s whole purpose is being honest about where information comes from. The trial was funded by the National Institutes of Health, which is about as independent as medical research funding gets. Several of its authors also declare consulting relationships, research support, or equipment from hearing aid manufacturers. In a field this small that is normal and it was openly declared. It is not a reason to dismiss the trial. It is a reason to mention it.

A follow-up study of the same participants is running now, and it should tell us whether the effect holds over a longer period. That is the result worth waiting for.

Does this apply to over-the-counter hearing aids?

Nobody has tested that, and it is not a small gap. The trial did not simply hand people a device. Participants received hearing aids fitted by an audiologist, plus counseling, a self-management toolkit, and ongoing instruction over three years. That is a package of professional care, not a purchase.

Since 2022, the FDA has allowed hearing aids to be sold over the counter in the US to adults with perceived mild to moderate hearing loss, with no hearing test, no professional fitting, and no follow-up included. That has made hearing help dramatically cheaper and more accessible, which is a genuinely good thing. But a self-fitted device bought online is a different intervention from the one that was studied, and it would be wrong to assume the falls result transfers to it.

What do hearing aids cost, and will Medicare pay?

Original Medicare does not cover hearing aids or the exams to fit them. Parts A and B pay for a diagnostic hearing test if a doctor orders one to investigate a medical problem, but not for the devices. Most Medicare Advantage plans do offer some hearing benefit, usually an allowance per ear on a multi-year cycle, and those vary enormously between plans.

On price, I am going to give you ranges rather than a figure, because the sources genuinely disagree. Checking several on the same day in 2026, over-the-counter devices ranged from under $100 to around $2,700 a pair, with typical reported spending somewhere between $200 and $900. Prescription hearing aids fitted at a clinic commonly ran $2,000 to $8,000 a pair, with warehouse clubs landing well below traditional clinics for comparable technology. Reported averages varied by thousands of dollars depending on who was surveyed and how.

Treat any single price you read, including mine, as a starting point rather than a quote. Three practical routes are worth knowing: HSA and FSA funds can be used for both types, enrolled veterans can get hearing aids through the VA, and some state Medicaid programs cover them. Your local Area Agency on Aging can tell you what exists in your parent’s county, and that call is free.

What the evidence does NOT support

• That hearing aids are a proven fall prevention treatment. No trial has tested falls as its main question. The one positive result is a secondary, exploratory finding awaiting confirmation.
• That the 51% figure describes your parent’s risk. That is a cross-sectional snapshot. Following people over time, the increase was about 17%, and neither number proves the hearing loss caused anything.
• That the association proves causation. Hearing loss arrives with age, frailty, and illness, and the balance organ sits beside the hearing organ and can be damaged by the same thing. Hearing loss may be a marker rather than a cause.
• That the trial result transfers to over-the-counter devices. What was tested was professional fitting plus three years of audiologist support. That is not the same as a self-fitted device bought online.
• That treating hearing loss substitutes for fall prevention. The interventions with the strongest evidence for preventing falls remain strength and balance exercise and reviewing medications. Nothing here changes that.
• That hearing aids improve everything. In the same trial, hearing aids did not slow cognitive decline overall and did not increase physical activity. Reporting only the positive outcome from a study with several null ones gives a misleading picture.

So what would I actually do?

Get the hearing checked, and treat any fall benefit as a bonus rather than the reason. Hearing loss is worth addressing on its own terms. It isolates people, makes conversation exhausting, and shrinks the world in ways families often mistake for personality change. Those reasons are sufficient without needing falls in the argument at all.

• Start with a hearing test. Original Medicare covers a diagnostic test when a doctor orders one for a medical reason. That establishes what kind of hearing loss it is, which determines whether an over-the-counter device is even appropriate.
• Ask about earwax first. It is common, it causes real hearing loss, and it is quickly fixed.
• If the loss is mild to moderate and in both ears, an over-the-counter device is a reasonable and much cheaper starting point.
• If it is severe, one-sided, or sudden, that needs a professional, not a purchase.
• Do the fall prevention separately. Do not let a hearing aid become the thing that gets done instead of exercise, a medication review, and a look around the house.

When to get help

• Sudden hearing loss is urgent. Hearing that drops suddenly, especially in one ear, should be seen quickly rather than waited out.
• Dizziness alongside hearing changes needs a doctor, since that combination points toward the balance system rather than hearing alone.
• After any fall, ask for a proper falls assessment rather than buying equipment. Start with what to do when a parent keeps falling.
• If they have stopped going out, it is worth working out whether that is hearing, confidence, or both. I have written about fear of falling and what helps.
• If vision is also declining, that combination deserves attention, and the evidence there is genuinely surprising. See what glasses do to fall risk.

Key takeaways

• People with hearing loss fall more often. Followed over time, the increase in risk is about 17%, smaller than the widely quoted snapshot figure of 51%.
• Whether hearing loss causes falls is unresolved. The balance organ sits beside the hearing organ, so both may be damaged by the same thing.
• One 2025 trial found treating hearing loss cut falls by about 27% over three years. It was a secondary, exploratory outcome in a trial whose main question came back negative.
• That trial tested professionally fitted hearing aids plus three years of audiologist support, not a self-fitted device bought online.
• Get hearing checked because hearing matters. Treat any effect on falls as a bonus, and keep doing exercise and a medication review regardless.

Common questions

Does hearing loss cause falls in older adults?

It is associated with them, but causation is not established. Pooled data on over five million people found about 17% higher fall risk when people were followed over time. Hearing loss also arrives alongside age, frailty, and inner ear damage that can affect balance directly, so it may be a marker rather than a cause.

Do hearing aids prevent falls?

One randomized trial found about 27% fewer falls over three years among people given hearing aids and audiologist support. That was a secondary, exploratory outcome from a trial whose primary question, about cognitive decline, came back negative. It is promising evidence that needs confirming, not a proven fall prevention treatment.

Does Medicare cover hearing aids?

Original Medicare, Parts A and B, does not cover hearing aids or the exams to fit them. It does cover a diagnostic hearing test when a doctor orders one for a medical reason. Most Medicare Advantage plans include some hearing benefit, but the amount varies substantially by plan, so ask the specific plan.

Are over-the-counter hearing aids good enough?

For gradual, mild to moderate hearing loss in both ears, they are a reasonable and far cheaper starting point. They are not appropriate for severe loss, sudden loss, one-sided loss, or hearing loss with pain or dizziness. They also include no hearing test, professional fitting, or follow-up care in the price.

How much do hearing aids cost?

Over-the-counter devices ranged from under $100 to around $2,700 a pair when I checked in 2026, with typical spending between about $200 and $900. Prescription hearing aids fitted at a clinic commonly ran $2,000 to $8,000. Sources disagree substantially on averages, so confirm current pricing directly rather than trusting any single figure.

Why would hearing affect balance at all?

Two plausible reasons, neither proven. Sound provides information about your surroundings, so losing it removes cues about what is nearby. Straining to hear also occupies mental attention that would otherwise help with walking. Separately, the balance organ sits beside the hearing organ in the inner ear, so damage can affect both.

Should my parent get hearing aids to reduce their fall risk?

Get them because hearing loss is worth treating in itself, for conversation, connection, and quality of life. The fall evidence is encouraging but not settled, so I would treat any benefit there as a bonus rather than the deciding argument. Keep doing the things with stronger fall evidence regardless.

What actually prevents falls, if not this?

Strength and balance exercise has the strongest evidence of anything in the falls field. A medication review can remove drugs quietly causing unsteadiness. Sorting hazards and lighting helps people at genuine risk. These are unglamorous and mostly free, and they outrank every device and supplement I have looked at on this site.

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Medical disclaimer. I am a public health graduate, not a physician or an audiologist, and this article is general information rather than medical advice. Hearing loss has many causes, some of which need proper medical investigation, and only an in-person assessment can tell you which applies. Please have your parent’s hearing evaluated by their doctor or a qualified hearing professional rather than relying on anything you read here.

A note on the evidence. The trial described here published in June 2025 and a follow-up study of the same participants is ongoing. This is a fast-moving area, and I will update this article when longer-term results appear.