The Association between Hearing Impairment and Postural Stability in Older Adults: A Systematic Review and Meta-analysis.

Most included studies (18 of 25) were cross-sectional, so the direction of the relationship cannot be established. Hearing loss and balance decline may both result from shared ageing processes. Heterogeneity was high for gait speed (I-squared 92 to 96%) and SPPB (I-squared 78 to 86%), partly because gait speed was measured over distances ranging from 2.4 m to 10 m and at different paces across studies. Hearing impairment was defined differently across studies: some used pure-tone average in the better ear, others in both ears, and one used a screening device that classified by worst ear. Three studies relied on self-report rather than audiometry. Participant ages varied by more than 15 years between studies, and recruitment methods differed (clinic patients, university pools, national samples). Only two of the 25 studies justified their sample size, and five used convenience sampling with different recruitment for hearing-impaired and normal-hearing groups.

The work was supported by Sonova AG (a hearing aid manufacturer) as part of a larger study series. The authors declared no conflicts of interest and stated that the sponsor was not involved in study design, data collection, analysis, interpretation, manuscript writing, or the decision to submit.

This is an association, not a treatment effect. No study in the review tested whether treating hearing loss improves balance, and most designs are cross-sectional, so causation cannot be established. The mild hearing loss group showed no significant difference in sit-to-stand time or the overall mobility score, so do not assume the same degree of balance impairment across all hearing loss severities.