A hearing consultation. Editorial illustration.
A study of older adults in China found that people with low estimated muscle mass were more likely to have difficulty hearing interview questions. The association persisted after researchers accounted for factors including age, smoking, physical activity and some chronic conditions. Because the study measured muscle and hearing at the same time, it leaves open which came first and whether one affects the other.
Evidence level Human Observational Research. The study used a single survey wave and estimated muscle mass from body measurements.
How the researchers measured muscle and hearing
The Scientific Reports study used the 2017–2018 wave of the Chinese Longitudinal Healthy Longevity Survey. It included 13,532 adults aged 65 and older, about 78% of whom were at least 75. The researchers estimated skeletal muscle mass in the arms and legs from age, sex, weight, height and calf circumference. They used sex-specific thresholds to classify low muscle mass.
Trained interviewers judged whether participants could hear questions clearly. Participants who could hear only partly or could not hear the interviewer were classified as having hearing impairment. The survey did not measure hearing thresholds with an audiogram, so the result captures hearing difficulty in that setting and may miss milder impairment.
How large was the association?
About 19% of the study group met the hearing impairment definition. In the fully adjusted analysis, participants without low muscle mass had 45% lower odds of hearing impairment than those with low muscle mass. The odds ratio was 0.55, with a 95% confidence interval of 0.45 to 0.67. The overall pattern appeared in both men and women.
Odds compare the likelihood of an outcome with the likelihood of it not occurring. The 45% figure describes adjusted odds. It does not tell readers how much a person’s probability of hearing difficulty would change if their muscle mass increased.
What might connect muscle and hearing
Inflammation and changes in circulation could affect both muscle and the inner ear. Hearing difficulty could also limit social or physical activity, which might in turn affect muscle. The study did not test these pathways. Lifetime noise exposure and genetic susceptibility were among the factors the researchers could not rule out.
Muscle health matters for everyday tasks such as getting up from a chair, climbing stairs and maintaining mobility. This finding adds hearing to the list of outcomes worth studying alongside muscle health. A stronger test would follow people over time, use direct measures of muscle mass and hearing, and account for noise exposure. For now, the study gives no evidence that building muscle prevents hearing loss.
Related reading on the genetics of muscle weakness and longevity.
Original research
Wu C, Zhang T, Liu Y, et al. Association between low muscle mass and hearing impairment in older adults: results from a national cross-sectional study. Scientific Reports, November 11, 2026.