Hearing impairment and its association with falls in older adults living in high Andean communities

Purpose – Falls are a major geriatric syndrome with multifactorial origins, including sensory deficits such as hearing impairment. However, evidence from older adults living in high Andean communities remains scarce. This study aims to analyze the association between hearing impairment and falls in this population. Design/methodology/approach – An observational, analytical, retrospective study was conducted using data from the Andes Frail Project (2012–2020). The sample included 452 adults aged ≥60 years from 12 Peruvian Andean communities located ≥1500 m above sea level. Falls were assessed by self-report within the past year, while hearing impairment was measured through the question: “Do you have hearing problems that limit your daily life?”. Covariables included sociodemographic characteristics, functional status, comorbidities, hospitalizations and polypharmacy. Associations were analyzed using Poisson regression with robust variance to estimate prevalence ratios (PR) and 95% confidence intervals (CI). Findings – The mean age was 72.9 years (SD = 6.9), and 63.0% were women. Hearing impairment was reported by 60.6% of participants, and 37.8% experienced falls. In bivariate analysis, falls were significantly associated with age, marital status, comorbidities, functional dependence, polypharmacy, hospitalizations, balance disorders, altitude and type of community. In multivariate analysis, hearing impairment remained significantly associated with falls (adjusted PR = 1.13; 95% CI: 1.06–1.29). Additional risk factors included being divorced, having one or more comorbidities, functional dependence and hospitalization history. Originality/value – This study shows that hearing impairment was independently associated with a higher prevalence of falls among older adults in high Andean communities. These findings highlight the importance of routine sensory evaluations and integrated, person-centered care strategies, such as those proposed by the Integrated Care for Older People framework, to reduce fall-related adverse outcomes in underserved rural populations.