Aging is one of the most common hearing loss clues and let’s face it, as hard as we might try, we can’t stop aging. But were you aware hearing loss has also been connected to health concerns that are treatable, and in some cases, preventable? Here’s a look at several cases that will surprise you.

1: Diabetes

Over 5,000 American adults were evaluated in a 2008 study which revealed that diabetes diagnosed individuals were two times as likely to have some amount of hearing loss when analyzed with low or mid-frequency sounds. Impairment was also more probable with high-frequency sounds, but not as extreme. It was also determined by investigators that people who struggled with high blood sugar levels but not high enough to be diagnosed with diabetes, in other words, pre-diabetic, were 30 percent more likely to suffer from hearing loss than people with healthy blood sugar. A more recent 2013 meta-study (yup, a study of studies) determined that the connection between hearing loss and diabetes was consistent, even while controlling for other variables.

So the association between hearing loss and diabetes is pretty well established. But why should you be at higher danger of getting diabetes simply because you suffer from loss of hearing? The reason isn’t really well known. Diabetes is linked to a wide variety of health issues, and particularly, the eyes, extremities and kidneys can be harmed physically. One hypothesis is that the condition might impact the ears in a similar way, harming blood vessels in the inner ear. But general health management may be the culprit. A 2015 study underscored the connection between diabetes and loss of hearing in U.S veterans, but most notably, it discovered that those with unchecked diabetes, in other words, that those with untreated and uncontrolled diabetes, it discovered, suffered more. If you are concerned that you might be pre-diabetic or are suffering from undiagnosed diabetes, it’s necessary to speak to a doctor and get your blood sugar evaluated. By the same token, if you’re having problems hearing, it’s a smart idea to get it checked out.

2: Falling

You could have a bad fall. It’s not exactly a health issue, because it isn’t vertigo but it can lead to many other difficulties. Research carried out in 2012 revealed a strong link between the danger of falling and loss of hearing though you may not have suspected that there was a relationship between the two. Evaluating a trial of over 2,000 adults ages 40 to 69, scientists found that for every 10 dB increase in hearing loss (for reference, normal breathing is about 10 dB), the risk of falling increased 1.4X. This connection held up even for individuals with mild hearing loss: Within the previous twelve months individuals who had 25 dB of hearing loss were more likely to have fallen than individuals with normal hearing.

Why would you fall because you are having trouble hearing? There are quite a few reasons why hearing problems can lead to a fall aside from the role your ears play in balance. Though this research didn’t go into what was the cause of the subject’s falls, the authors believed that having problems hearing what’s around you (and missing an important sound such as a car honking) may be one issue. But if you’re having difficulties paying attention to sounds near you, your split attention means you might not be paying attention to your physical environment and that may end up in a fall. The good news here is that managing hearing loss may possibly reduce your risk of suffering a fall.

3: High Blood Pressure

Several studies (such as this one from 2018) have shown that loss of hearing is connected to high blood pressure and some (including this 2013 study) have observed that high blood pressure could actually quicken age-related hearing loss. It’s a connection that’s been seen rather consistently, even while controlling for variables such as noise exposure and whether you’re a smoker. Gender is the only variable that appears to matter: The link betweenhearing loss and high blood pressure, if your a male, is even stronger.

Your ears are quite closely related to your circulatory system: Two main arteries are very near to the ears not to mention the little blood vessels inside them. This is one explanation why individuals who have high blood pressure often suffer from 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.) The leading theory for why high blood pressure could speed up loss of hearing is that high blood pressure can also cause permanent injury to your ears. Each beat has more force if your heart is pumping harder. The smaller blood vessels in your ears could potentially be damaged by this. High blood pressure is controllable, through both lifestyle changes and medical interventions. But if you suspect you’re suffering from loss of hearing even if you believe you’re too young for the age-related stuff, it’s a good move to consult a hearing care professional.

4: Dementia

Hearing loss might put you at higher risk of dementia. 2013 research from Johns Hopkins University that was documented after almost 2,000 individuals in their 70’s over the course of six years found that the chance of cognitive impairment increased by 24% with only mild hearing loss (about 25 dB, or slightly louder than a whisper). A 2011 study by the same researchers which followed subjects over more than ten years found that the worse a subject’s hearing was, the more probably it was that they would develop dementia. (They also uncovered a similar connection to Alzheimer’s Disease, even though it was less substantial.) Based on these conclusions, moderate hearing loss puts you at 3 times the risk of someone who doesn’t have hearing loss; severe hearing loss nearly quintuples one’s risk.

It’s alarming stuff, but it’s significant to recognize that while the link between loss of hearing and cognitive decline has been well documented, researchers have been less successful at sussing out why the two are so strongly linked. A common theory is that having trouble hearing can cause people to avoid social interactions, and that social isolation and lack of mental stimulation can be incapacitating. Another theory is that loss of hearing overloads your brain. In other words, because your brain is putting so much of its recourses into comprehending the sounds around you, you may not have very much energy left for remembering things such as where you left your keys. Staying in close communication with friends and family and doing crosswords or brain games could help here, but so can dealing with hearing loss. Social circumstances become much more overwhelming when you are contending to hear what people are saying. So if you are coping with loss of hearing, you need to put a plan of action in place including getting a hearing exam.