How important is the health of our inner ear as we age?

Answers by Brooke Steckelberg, Au.D., CCC-A 

Legendary comedian George Burns once said, “You can’t help getting older, but you don’t have to get old.” 

Brooke Steckelberg, Au.D., CCC-A  Contributed photo

Some days, of course, that’s easier said than done. I often see patients who are determined to stay healthy and independent, and one key—but often overlooked—factor in aging well is the inner ear, which plays a crucial role in both balance and overall health.

As people age, their hearing and balance change in ways that can quietly chip away at independence. Hearing loss (presbycusis) and age-related decline in vestibular (inner-ear balance) function are common. 

Hearing and balance aren’t just about listening or staying upright. Reduced hearing clarity can make conversations tiring, increase social withdrawal and raise the cognitive load required to follow speech in noisy places. Decline of the inner-ear balance function may slow reflexes that stabilize gaze and posture and contribute to unsteadiness and an increased risk of falling. Falling is one of the leading causes of injury and loss of independence in older adults, and observational studies have linked greater hearing loss to more frequent falls. 

As we age, the inner ear and neural connections degenerate, reducing hearing and speech understanding. In the vestibular system, sensory cells, nerve fibers and the processing of vestibular signals gradually decline, which could affect two primary balance reflexes. These are the vestibulo-ocular reflex (VOR), which stabilizes the gaze during head movements so that vision remains clear, and the vestibulospinal reflexes, which help maintain posture and balance by sending signals to muscles in the trunk and limbs. These are gradual, cumulative processes influenced by genetics, noise exposure, cardiovascular health, diseases such as diabetes and kidney disease and other chronic conditions. 

Five Evidence-Based Steps to Preserve Your Independence

1. Routine hearing screening and early care: Get regular hearing checks—early identification lets you access treatment options that restore communication and confidence sooner. 

2. Hearing rehabilitation: Hearing aids and other assistive listening devices can improve communication, reduce listening effort and increase social engagement. While the causal link between hearing treatment and long-term dementia prevention remains under study, we do know that treating hearing loss improves quality of life and daily functioning. 

3. Protect hearing: Limit loud noise exposure, use hearing protection and manage medical risks (blood pressure, diabetes) that affect inner-ear health. 

4. Balance training and vestibular therapy: Exercise regularly to regain steadiness. Even simple movements like heel-to-toe walking, standing on one leg and turning your head back and forth while walking can help. More difficult movements like tai chi and yoga have also been shown to help balance function. If you have more significant balance concerns, see a physical therapist or personal trainer for personalized exercises. 

5. Home safety and multifactor fall prevention: Remove trip hazards, improve lighting and use assistive devices when needed to preserve independence.  

Aging doesn’t have to mean losing independence. By following the five steps above, older adults can keep talking, moving and living well on their own terms.

Find out more

If you are interested in learning more about inner ear health, please call St. Cloud ENT at (320) 252-0233 and schedule a visit with one of our audiologists.

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