Professional Guidelines and Reported Practice of Audiologists Performing Fall Risk Assessment With Older Adults: A Systematic Review

Abstract

Purpose: This systematic review aimed to explore the recommended fall risk assessment practices in audiology, identify audiologists' reported practices in fall risk assessment, and recognize the barriers and facilitators affecting fall risk assessment in clinical practice. Method: This systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Results: CINAHL, PubMed, and gray literature yielded 262 articles. A total of 27 full-text articles were included in this review article. An additional 16 scope of practice and guideline documents were also reviewed. Pertinent data and findings from the review were tabulated and analyzed using a qualitative, inductive approach. Conclusions: Results revealed that despite fall risk assessment measures and protocols being mentioned, discussed, and reportedly implemented clinically in audiology literature, many audiologists are not conducting fall risk assessments clinically. The main challenges presented appear to be due to limited guidance within audiology documentation and inadequate training and knowledge of audiologists on fall risk factors and measures. This review article highlighted that all audiologists have an important role to play in reducing the global crisis of falls in older adults. However, without further research to aid in the development of standardization of documentation and training programs, we may continue to see a lack of awareness and education on fall risk and on the audiologist's role in the screening and early detection hereof.

The significance of right ear auditory processing to balance

“…Specifically, right ear processing is significantly more efficient for speech stimuli 7 . In recent years, a growing body of evidence has suggested that hearing cues contribute to balance 8,9 . Studies show that auditory information can be integrated with vestibular, somatosensory, and visual signals to improve balance, orientation, and gait [10][11][12][13] .…”

“…One of the first signs of hearing deterioration is difficulty in understanding speech in challenging everyday listening situations [15][16][17][18][19] . However, very little is known about the interaction between the deterioration of speech perception and balance.Falling and its consequences have a significant impact on individuals (loss of quality of life, nursing home admissions) and society (healthcare costs) 9,13 . Early detection of balance disorders and possible interventions can potentially reduce falling and prevent its consequences 13 .…”

“…Recent studies have shown that auditory information can be integrated with vestibular, somatosensory, and visual signals to improve balance, orientation, and gait [10][11][12][13] . However, hearing status is rarely taken into account when evaluating gait and balance 8,9 .To respond to these needs, the current study examined the interaction between hearing and balance in a group of adults, using functional indices of hearing and balance. It then explored the relative contribution of the left versus right ear at different frequencies to balance.…”

“…Falling and its consequences have a significant impact on individuals (loss of quality of life, nursing home admissions) and society (healthcare costs) 9,13 . Early detection of balance disorders and possible interventions can potentially reduce falling and prevent its consequences 13 .…”

“…Recent studies have shown that auditory information can be integrated with vestibular, somatosensory, and visual signals to improve balance, orientation, and gait [10][11][12][13] . However, hearing status is rarely taken into account when evaluating gait and balance 8,9 .…”