Aging is one of the most typical signals of hearing loss and truth be told, as hard as we might try, we can’t escape aging. But were you aware loss of hearing has also been connected to health problems that are treatable, and in some cases, can be avoided? You could be surprised by these examples.

1: Diabetes

A widely-quoted 2008 study that evaluated over 5,000 American adults revealed that individuals who had been diagnosed with diabetes were two times as likely to have mild or greater hearing loss when mid or low frequency sounds were used to screen them. High frequency impairment was also possible but less severe. It was also discovered by researchers that individuals who struggled with high blood sugar levels but not so high as to be diagnosed with diabetes, in other words, pre-diabetic, were more likely by 30 percent than people who had healthy blood sugar levels, to have loss of hearing. A more recent 2013 meta-study (that’s right, a study of studies) revealed that there was a persistent association between loss of hearing and diabetes, even while taking into account other variables.

So the association between hearing loss and diabetes is pretty well founded. But why would you be at increased danger of getting diabetes just because you have loss of hearing? Science is at a bit of a loss here. Diabetes is linked to a number of health problems, and notably, the kidneys, extremities, and eyes can be physically harmed. One hypothesis is that the the ears may be similarly affected by the disease, blood vessels in the ears being harmed. But overall health management might be the culprit. A 2015 study highlighted the connection between diabetes and hearing loss in U.S veterans, but most notably, it discovered that people with unchecked diabetes, in essence, people suffered even worse if they had untreated and uncontrolled. If you are worried that you may be pre-diabetic or have undiagnosed diabetes, it’s necessary to speak to a doctor and get your blood sugar checked. It’s a good idea to get your hearing tested if you’re having a hard time hearing too.

2: Falling

You could have a bad fall. It’s not really a health problem, because it’s not vertigo but it can trigger many other difficulties. And while you may not realize that your hearing could affect your likelihood of slipping or tripping, research from 2012 revealed a considerable link between hearing loss and fall risk. Examining a trial of over 2,000 adults ages 40 to 69, researchers discovered that for every 10 dB increase in hearing loss (for reference, normal breathing is about 10 dB), the danger of falling increased 1.4X. This relationship held up even for individuals with mild hearing loss: Those with 25 dB hearing loss were 3 times as likely as those with normal hearing to have fallen within the previous year.

Why would having trouble hearing make you fall? There are a number of reasons why hearing issues can lead to a fall besides the role your ears have in balance. Though the reason for the individual’s falls wasn’t examined in this study,, the authors theorized that having difficulty hearing what’s going on around you you (and missing an important sound like a car honking) may be one issue. But it could also go the other way if difficulty hearing means you’re concentrating on sounds rather than paying attention to what’s around you, it may be easy to trip and fall. The good news here is that managing loss of hearing might possibly minimize your chance of suffering a fall.

3: High Blood Pressure

Several studies (including this one from 2018) have shown that loss of hearing is connected to high blood pressure and some (including this 2013 study) have shown that high blood pressure might actually quicken age-related hearing loss. Even after controlling for variables including noise exposure or if you smoke, the connection has been pretty consistently revealed. Gender is the only variable that seems to matter: If you’re a guy, the connection between hearing loss and high blood pressure is even stronger.

Your ears aren’t part of your circulatory system, but they’re pretty close to it: Two main arteries are very near to the ears as well as the tiny blood vessels inside them. This is one reason why individuals who have high blood pressure often experience tinnitus, the pulsing they’re hearing is actually their own blood pumping. (That’s why this kind of tinnitus is called pulsatile tinnitus; it’s your pulse your hearing.) But high blood pressure may also possibly cause physical damage to your ears which is the leading theory behind why it would speed up hearing loss. Each beat has more pressure if your heart is pumping harder. That could possibly injure the smaller blood arteries inside your ears. High blood pressure is manageable, through both lifestyle changes and medical interventions. But if you suspect you’re dealing with loss of hearing even if you think you’re not old enough for the age-related stuff, it’s a good idea to speak with a hearing specialist.

4: Dementia

Chances of dementia could be higher with loss of hearing. A six year study, started in 2013 that followed 2,000 people in their 70’s found that the chance of mental impairment increased by 24% with only minimal hearing loss (about 25 dB, or slightly louder than a whisper). 2011 research by the same research group which analyzed subjects over more than 10 years discovered that when the subject’s hearing got worse, the more likely it was that they would develop dementia. (They also found a similar link to Alzheimer’s Disease, even though it was less significant.) moderate hearing loss, based on these findings, puts you at 3X the risk of a person without hearing loss; severe loss of hearing nearly quintuples one’s chance.

However, even though experts have been successful at documenting the link between loss of hearing and cognitive decline, they still aren’t sure as to why this occurs. A common hypothesis is that having problems hearing can cause people to avoid social situations, and that social withdrawal and lack of mental stimulation can be debilitating. A different hypothesis is that hearing loss short circuits your brain. Essentially, because your brain is putting so much energy into understanding the sounds around you, you may not have very much energy left for remembering things like where you put your medication. Maintaining social ties and keeping the brain active and challenged could help here, but so can dealing with hearing loss. Social circumstances become much more confusing when you are struggling to hear what people are saying. So if you are dealing with loss of hearing, you should put a plan of action in place including having a hearing exam.