Age-related hearing loss (ARHL) and impaired gait both independently heighten the risk of accidental falls among older adults. However, the combined impact of these factors remains unclear. We analyzed the data of 786 community-dwelling Japanese older adults. Hearing was evaluated at frequencies of 1.0 and 4.0 kHz, with participants categorized into ARHL (> 25 dB) and non-ARHL groups. Gait was also assessed, defining slow gait (SG) as speeds one standard deviation below the age- and sex-specific mean. Participants were divided into four groups based on their ARHL and SG statuses and were monitored annually for 8 years to track falls and related injuries. Throughout the follow-up, incidents included 328 single falls (9.6/100 person-years), 117 multiple falls (2.8/100 person-years), 249 minor injuries from falls (6.7/100 person-years), and 55 fractures due to falls (1.3/100 person-years). Cox proportional hazard regression models showed that participants without ARHL but with SG faced a significantly increased risk of frequent falls. Furthermore, ARHL combined with SG significantly raised the risk of both single and frequent falls, and increased the incidence of both minor and severe fall-related injuries, including fractures. In contrast, no significant association was found between ARHL alone and fall-related incidents. These findings suggest that the previously reported risk associated with hearing loss in fall incidents predominantly relates to gait impairment. The co-occurrence of ARHL and SG significantly escalates the risk of falls and related injuries, highlighting the critical need for routine gait monitoring.

年龄相关性听力损失 （ARHL） 和步态受损都独立地增加了老年人意外跌倒的风险。然而，这些因素的综合影响仍不清楚。我们分析了 786 名居住在社区的日本老年人的数据。在 1.0 和 4.0 kHz 的频率下评估听力，参与者分为 ARHL （> 25 dB） 和非 ARHL 组。还评估了步态，将慢步态 （SG） 定义为比年龄和性别特异性平均值低一个标准差的速度。参与者根据他们的 ARHL 和 SG 状态分为四组，并每年接受 8 年的监测，以跟踪跌倒和相关损伤。在整个随访过程中，事件包括 328 次单次跌倒 （9.6/100 人年）、117 次多次跌倒 （2.8/100 人年）、249 例跌倒轻伤 （6.7/100 人年） 和 55 例跌倒骨折 （1.3/100 人年）。Cox 比例风险回归模型显示，没有 ARHL 但有 SG 的参与者面临频繁跌倒的风险显着增加。此外，ARHL 联合 SG 显着增加了单次和频繁跌倒的风险，并增加了轻微和严重跌倒相关损伤（包括骨折）的发生率。相比之下，单独使用 ARHL 与跌倒相关事件之间没有发现显著关联。这些发现表明，先前报道的与跌倒事件中听力损失相关的风险主要与步态障碍有关。ARHL 和 SG 的共存显着增加了跌倒和相关伤害的风险，凸显了常规步态监测的迫切需求。