Aging is one of the most common signals of hearing loss and let’s face it, try as we may, we can’t avoid aging. But were you aware hearing loss has also been connected to health problems that are treatable, and in certain circumstances, can be avoided? You could be surprised by these examples.

1: Diabetes

A widely-cited 2008 study that examined over 5,000 American adults revealed that diabetes diagnosed individuals were twice as likely to suffer from mild or more hearing loss when mid or low frequency tones were used to test them. High frequency impairment was also likely but not as severe. It was also discovered by analysts that people who struggled with high blood sugar levels but not high enough to be defined as diabetes, put simply, 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 (you got it, a study of studies) found that there was a consistent connection between hearing loss and diabetes, even while controlling for other variables.

So the association between hearing loss and diabetes is pretty well demonstrated. But why should you be at greater risk of getting diabetes just because you suffer from hearing loss? Science is somewhat at a loss here. Diabetes is linked to a wide range of health concerns, and particularly, the kidneys, extremities, and eyes can be physically injured. One theory is that the condition might affect the ears in a similar manner, damaging blood vessels in the inner ear. But general health management could be the culprit. A 2015 study that looked at U.S. military veterans highlighted the connection between loss of hearing and diabetes, but particularly, it discovered that people with uncontrolled diabetes, in essence, that those with uncontrolled and untreated diabetes, it found, suffered more. If you are concerned that you may be pre-diabetic or are suffering from undiagnosed diabetes, it’s important to consult with a doctor and get your blood sugar evaluated. It’s a good idea to get your hearing examined if you’re having trouble hearing too.

2: Falling

All right, this is not really a health issue, since we aren’t talking about vertigo, but going through a bad fall can trigger a cascade of health problems. And while you might not realize that your hearing would affect your likelihood of slipping or tripping, research from 2012 revealed a substantial connection between hearing loss and fall risk. While studying over 2,000 adults between the ages of 40 to 69, researchers found that for every 10 dB rise in loss of hearing (as an example, normal breathing is about 10 dB), the chance of falling increased 1.4X. This link held up even for those with mild hearing loss: Those with 25 dB hearing loss were 3 times as likely as those with normal hearing to have had a fall within the past 12 months.

Why should you fall because you are having difficulty hearing? There are a number of reasons why hearing issues can lead to a fall aside from the role your ears play in balance. Although this research didn’t go into what was the cause of the participant’s falls, it was theorized by the authors that having problems hearing what’s going on around you you (and missing an important sound like a car honking) may be one problem. 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 might be easy to trip and fall. What’s promising here is that managing hearing loss could possibly minimize your risk of suffering a fall.

3: High Blood Pressure

Several studies (including this one from 2018) have found that loss of hearing is linked to high blood pressure and some (including this 2013 research) have observed that high blood pressure may actually quicken age-related hearing loss. It’s a link that’s been found fairly consistently, even while controlling for variables including noise exposure and whether you’re a smoker. Gender is the only variable that appears to make a difference: If you’re a male, the connection between loss of hearing and high blood pressure is even stronger.

Your ears are very closely related to your circulatory system: Two main arteries are very near to the ears not to mention the tiny blood vessels inside them. This is one explanation why people who have high blood pressure often suffer from tinnitus, it’s actually their own blood pumping that they’re hearing. (That’s why this kind of tinnitus is called pulsatile tinnitus; you’re hearing your own pulse.) But high blood pressure might also potentially be the cause of physical damage to your ears which is the primary theory behind why it would accelerate hearing loss. If your heart is pumping harder, there’s more force every time it beats. That could potentially injure the smaller blood arteries inside your ears. High blood pressure is controllable, through both medical interventions and lifestyle change. But if you think you’re suffering with hearing loss even if you think you’re not old enough for the age-related problems, it’s a good decision to schedule an appointment with a hearing expert.

4: Dementia

Risk of dementia could be higher with loss of hearing. 2013 research from Johns Hopkins University that followed about 2,000 people in their 70’s over the course of six years revealed that the risk of cognitive impairment increased by 24% with just mild loss of hearing (about 25 dB, or slightly louder than a whisper). It was also revealed, in a study from 2011 conducted by the same group of researchers, that the danger of dementia raised proportionally the worse hearing loss became. (Alzheimer’s was also found to have a similar connection, even though it was less significant.) moderate hearing loss, based on these findings, puts you at three times the danger of somebody who doesn’t have hearing loss; one’s danger is raised by nearly 4 times with significant hearing loss.

It’s frightening stuff, but it’s important to recognize that while the link between loss of hearing and cognitive decline has been well recognized, experts have been less effective at sussing out why the two are so solidly connected. If you can’t hear well, it’s difficult to interact with people so the theory is you will avoid social situations, and that social isolation and lack of mental stimulation can be incapacitating. A different hypothesis is that hearing loss overloads your brain. Essentially, trying to hear sounds around you fatigues your brain so you may not have much juice left for recalling things like where you put your medication. Staying in close communication with friends and family and keeping the brain active and challenged could help here, but so can dealing with hearing loss. If you’re capable of hearing clearly, social situations are easier to handle, and you’ll be able to focus on the critical stuff instead of trying to understand what someone just said. So if you are coping with loss of hearing, you should put a plan of action in place including getting a hearing test.