title: Hearing loss and falls: A systematic review and meta-analysis.
abstract: Falls are a devastating condition in older individuals. Identifying potentially modifiable risk factors such as hearing loss would provide a substantial public health benefit.
  
  
  
  To evaluate the current evidence for an association between hearing loss and falls risk.
  
  
  
  A systematic search of PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Scopus, Web of Science, and Cochrane databases was performed in July 2014.
  
  
  
  Studies were eligible for inclusion if they were published in the peer-reviewed literature. All studies used a predetermined definition of hearing loss. Main outcomes and measurements were fall hospitalization records or self-reports of falls by structured interview or validated questionnaires.
  
  
  
  Two investigators independently reviewed the literature related to hearing loss, falls, and older adults. We pooled effect sizes from across the studies and performed a meta-analysis to compute an overall effect size.
  
  
  
  Twelve eligible studies were identified. The odds of falling were 2.39 times greater among older adults with hearing loss than older adults with normal hearing (pooled odds ratio 2.39, 95% confidence interval [CI]: 2.11-2.68). In sensitivity analyses, we restricted the meta-analysis to studies where hearing loss was audiometrically defined (N = 6) and observed hearing loss to be associated with a 69% increase in the odds of falling (pooled odds ratio 1.69, 95% CI: 1.18-2.19). When we further limited to studies that also performed multivariate regression analyses (N = 4), the overall effect size did not appreciably change (pooled odds ratio 1.72, 95% CI: 1.07-2.37). We observed a potential positive publication bias in the literature. Limitations of the systematic review and meta-analysis are the cross-sectional designs of most studies and the heterogeneity across studies (Q = 631, P < .05, I2= 98.1%).
  
  
  
  In the published literature, hearing loss is associated with a significantly increased odds of falling in older adults. These findings need to be interpreted in light of the potential for positive publication bias in the literature on this topic.
  
  
  
  NA Laryngoscope, 126:2587-2596, 2016.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Nicole Tin-Lok
authors.initials: NT
authors.lastname: Jiam
authors.affiliation: Department of Otolaryngology, New York-Presbyterian Hospital, New York, New York, U.S.A.
authors.forename: Carol
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland. yagrawa1@jhmi.edu.
authors.forename: Yuri
authors.initials: Y
authors.lastname: Agrawal
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D034381:Hearing Loss / Q000150:complications*; D006801:Humans; D016017:Odds Ratio; D012307:Risk Factors
keywords: Hearing loss; falls; meta-analysis; older adults; risk factors; systematic review