Do you suffer from hearing loss? You might not even know it. There are a lot of factors that can contribute to a subtle decline in hearing, such as exposure to loud noises, impact on the head, exposure to certain chemicals, medications, or just changes to the inner ear as we age. It’s estimated that 1 in 8 people ages 12 or older suffer from hearing loss in both ears, based on standard examinations, making the likeliness that you or someone you care for has hearing loss relatively high.

Hearing loss can go on for years without realizing it’s there, however the side effects may already be occurring, even without a diagnosis. Do you struggle to follow a conversation in noisy settings? Do you find yourself asking what a lot? Do people ever describe sounds you just don’t hear? Because hearing loss occurs gradually it’s easy to not even notice it, even as it starts to threaten your health in various ways. Here are five reasons why you should check your hearing annually no matter your age.

Protect Your Relationships

Hearing loss is a communication issue above all else. As small misunderstandings start to build up they can affect every relationship in your life from casual acquaintances, professional contacts, and even your most intimate relationships. As small misunderstanding makes social interaction more difficult it’s common to withdraw, choosing isolation instead.

In your personal life, it can erode close connection even with your romantic partner. It’s the quiet moments in conversation that matter just as much as exchanging big ideas and information within partnerships. It’s the casual banter and inside jokes which builds intimacy. As this becomes less frequent due to hearing loss, it’s common for even the tightest knit of relationships to begin to unravel leaving loneliness and depression in its place. When you know you have a hearing loss, you can take action and treat it. Over time you can start to build back the integrity of your relationships.

Protect Your Career

In professional settings, hearing loss can affect performance, ultimately leading to loss of earnings and even unemployment. The Better Hearing Institute reports that those with untreated hearing loss make on average, annually 30,000 less than contemporaries with normal hearing.

Avoid Falling

Hearing aids not only help you hear the people in your life but keep you on your feet. A study by the Washington University School of Medicine in St. Louis found that older patients ranging from ages 65–to 91 who wore hearing aids in both ears performed better on standard balance tests. “We don’t think it’s just that wearing hearing aids makes the person more alert,” explains the study’s senior author, Timothy E. Hullar, professor of otolaryngology at the School of Medicine. “The participants appeared to be using the sound information coming through their hearing aids as auditory reference points or landmarks to help maintain balance. It’s a bit like using your eyes to tell where you are in space. If we turn out the lights, people sway a little bit — more than they would if they could see. This study suggests that opening your ears also gives you information about balance.

Better Manage Effects of Diabetes

If you’ve been diagnosed with diabetes, it’s reasonable to check for hearing loss annually. While about 10% of the US population lives with diabetes, one-third of people in the US are pre-diabetic, meaning they are at a risk for full-blown diabetes. Recent studies have identified that people with diabetes are twice as likely to have hearing loss as non-diabetic patients.

Ward Off Dementia

Not only does hearing loss make it harder to connect to the people in your life, but it can contribute to cognitive decline. Even a slight hearing loss will cause breaks in words and sentences requiring the brain to work overtime filling in the breaks. This is not only cognitively exhausting but takes away from other cognitive functions. A prominent study from Frank Lin, M.D., Ph.D. at the Johns Hopkins and National Institute on Aging determined that even a mild case of dementia doubled the risk of developing dementia early or at all. “Even after the researchers took into account other factors that are associated with risk of dementia, including diabetes, high blood pressure, age, sex, and race,” Lin explains, “(untreated) hearing loss and dementia were still strongly connected.