Background Age-related hearing loss is a prevalent condition among older individuals and it has significant implications for their overall well-being, particularly in terms of balance and function. A significant association between auditory decline, reduced quality of life, cognitive deterioration and an increased risk of dementia has been documented. Furthermore, previous findings suggest that the utilisation of hearing aids may provide significant benefits in maintaining balance. The overall aim of this research project was to investigate the associations between age-related hearing loss, balance and functional abilities in older individuals with an additional emphasis on assessing the effect of hearing aids on balance when standing as measured by posturography. The current literature is characterised by a predominance of studies with small sample sizes that heavily rely on subjective self-reports of hearing and physical performance. This reliance has resulted in a significant research gap due to the underutilisation of objective measurements. By addressing this deficiency of objective data, this investigation seeks to provide insights with important implications for clinical practices and interventions. These insights are intended to enhance the quality of life and functional independence of older individuals affected by hearing loss. Methods and Results Quantitative data from the population-based fourth wave of the North-Trøndelag Health Study (HUNT4) was utilised with a particular focus on the sub-study that included an extended examination of participants aged 70 years and older (Study 70+). The analysis included 4,101 participants (52.3% female, average age 76.3) who had complete data on their physical performance as measured by Short Physical Performance Battery (SPPB) and their hearing threshold by audiometry. The analyses revealed an association between an increased hearing threshold and reduced physical performance as measured by SPPB, both total scores and subscores. In study 2, 50 individuals with age-related hearing loss (>30 dB) and 50 individuals with normal hearing (≤30 dB) matched for age and sex, were included. The exclusion criteria were any medical condition that could significantly impact gait, balance or hearing. The participants (66% female, average age 76 years) underwent tests for physical performance, postural sway and gait variability using objective measurement tools: the SPPB, a force platform, and accelerometer. Hearing loss (the independent variable) was included as a dichotomous variable (hearing loss versus no hearing loss), while SPPB scores, postural sway and gait variability were outcome variables. The study revealed significant associations between hearing loss reduced SPPB total scores, increased postural sway and greater gait variability. The third study examined the differences in postural sway with and without using hearing aids. The participants were those with hearing loss from study 2. The participants were tested with and without the use of hearing aids while standing on a force platform under four conditions: firm surface with eyes open and eyes closed, foam surface with eyes open and eyes closed, first measured without hearing aids and afterwards tested with hearing aids. A paired-samples t-test showed that there was statistically significant better balance (reduced postural sway) while standing on a firm surface with the eyes open with hearing aids. There were no other significant differences. Multiple regression analysis showed no significant association between the hearing threshold and postural sway in any condition. Conclusion In this PhD project, it was found that hearing loss is associated with poorer physical performance and balance as well as increased gait variability. The balance measured on a firm surface and with the eyes open was significantly better when the participants used hearing aids versus not using them. The findings of these studies emphasise the need for comprehensive assessments of physical performance in individuals with hearing loss and to reinforce the benefits gained from motivating the elderly with hearing loss to use hearing aids. By improving the auditory input, hearing aids may play a fundamental role in enhancing balance and overall physical performance. This, in turn, contributes to fall prevention strategies and enhances the quality of life and independence for those affected by hearing impairments.