(This article was provided through The OpEd Project, whose mission is to increase the range of voices and quality of ideas we hear in the world.)

While a new study last month suggested exercise is the best way to prevent falls in people over 65, there’s another, surprisingly simple, but often overlooked way to reduce the risk of falling: a hearing test.

In 2012, researchers determined that even a mild hearing loss tripled the risk of an accidental fall; the risk increased by 140 percent for every 10 decibels of increased hearing loss in people over 40.

The study’s author, Johns Hopkins Associate Professor of Otolaryngology Frank Lin, theorized that hearing loss puts a larger cognitive load on the brain, which may reduce brain resources for balance.  If this seems unlikely, just try putting foam earplugs in: Although they create the equivalent of a 40-decibel hearing loss (considered mild), just tell me this doesn’t affect how you experience and move around in the world.

Hearing Loss: ‘A Silent Problem’

In addition to increasing the risk of falls, hearing loss is linked to diabetes, cognitive decline, multiple sclerosis, rheumatoid arthritis, depression and more. But unlike vision, hearing loss remains a silent problem. The reasoning behind this is multifaceted, but largely related to myths and stigma.

For instance, in my 25 years fitting hearing aids, I’ve often heard patients say their hearing aids make their natural hearing ability worse. But this is not the case. The brain is so hungry to get the stimuli, the hearing-impaired person just notices the “before” and “after” effect. The brain loves to have all of the aural information it had been missing, and the wearer has much better awareness of what it hadn’t been hearing once hearing aids are in place.

Hearing loss also carries a stigma that vision loss doesn’t — despite the inevitability of both senses declining with age. Glasses, unlike hearing aids, are a cool fashion accessory. Personally, I’ve had glasses since I was 4; my sister painted a flower garden on my lens when I needed an eyepatch. Now, nearing 50, I own several pairs of glasses in different shapes and colors to match my outfits. Hearing aids, on the other hand, are associated with age and infirmity.

Not Enough Attention From Medical Profession

It doesn’t help that the medical profession sometimes forgets about the importance of hearing. For instance, in 2013, the Centers for Disease Control acknowledged that diabetes affects hearing, but failed to mention until very recently that annual hearing exams should be required for those diagnosed with diabetes. Vision, on the other hand, has been a recommended test for diabetes for years.

If our vision changes, it’s often quite obvious to us. We hold the newspaper farther away or we can’t read street signs. Hearing loss can be much more subtle. We ask people to repeat themselves more or tell people they’re mumbling or get more tired trying to follow a conversation. That’s especially true in a noisy situation because we use more cognitive function to figure out what is being said. These changes happen over time, so many don’t realize it is happening.

The Need for Baseline Hearing Tests

Everyone needs a diagnostic hearing exam on a regular basis to provide a baseline to measure changes in our bodies. Without such a baseline, it becomes difficult to evaluate the impact of many things that may affect hearing — from chronic diseases like diabetes to medical treatments like chemotherapy to accidents. Without a diagnostic test on record, it can be difficult to prove that hearing changed.

Most commercial health insurance covers hearing exams, although some plans require a referral from a primary physician. Medicare, however, can be more complicated: It covers hearing exams related to medical issues (with a physician referral), including diabetes and vertigo, but not routine exams or for exams for hearing aids.

Many people need to be their own advocate in requesting hearing exams; seven in 10 adults who had a physical in the last year say it didn’t include a hearing test, according to the nonprofit Better Hearing Institute.

As our population ages, and more attention is focused on the impact of age, annual hearing evaluations must become the norm for adults — not the exception.

By Judy Huch

Judy Huch, Au.D., is the founder of the nonprofit Grace Hearing Center in Tucson and serves on the Arizona Commission for the Deaf and Hard of Hearing. She is an OpEd Project Public Voices Fellow.

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