Search

Importance: Perceived everyday discrimination is a psychosocial stressor linked to adverse health outcomes, including mortality., Objective: To assess the association of vision impairment (VI), hearing impairment (HI), and dual sensory impairments (DSI) with everyday discrimination., Design, Setting, and Participants: Cross-sectional analysis of the Health and Retirement Study 2006 and 2008 surveys, a US population-based survey that included noninstitutionalized adults 51 years and older. Analyses were weighted to account for complex sample design and differential nonresponse. Data were analyzed between October 2019 and November 2019., Exposures: Participants rated their vision and hearing, using eyeglasses and/or hearing aids if applicable, on a Likert scale (poor, fair, good, very good, and excellent). Sensory impairment was defined as poor or fair ability in the relevant modality, and sensory impairment was categorized as neither sensory impairment (NSI), VI alone, HI alone, and DSI., Main Outcomes and Measures: Perceived everyday discrimination was measured on the validated 5-question Williams scale (range 0 to 5). Linear regression models estimated differences in discrimination scores by sensory categories, adjusting for age, sex, race, ethnicity, non-US birth, body mass index, relationship status, net household wealth, and number of chronic diseases (among diabetes, hypertension, heart disease, stroke, lung disease, nonskin cancer, and arthritis)., Results: The sample included 13 092 individuals. After weighting the sample to be representative of the US population, 11.7% had VI alone, 13.1% HI alone, and 7.9% DSI. In the fully adjusted model, participants with VI alone (β [change in discrimination score], 0.07; 95% CI, 0.02-0.13), HI alone (β = 0.07; 95% CI, 0.02-0.11), and DSI (β = 0.23; 95% CI, 0.16-0.29) perceived greater discrimination compared with participants with NSI. The DSI group perceived greater discrimination than VI alone or HI alone., Conclusions and Relevance: Older adults with VI or HI in the United States perceive greater everyday discrimination than older adults with NSI, and those with DSI perceive even more discrimination than those with either VI or HI alone. These results provide insight into the social impact of sensory loss and highlight a need to identify and address reasons for discrimination toward older adults with VI and HI.

The present study aimed to examine the prevalence of dual sensory impairment, and to identify its risk factors among community-dwelling older adults in Selangor., Methods: Secondary analysis was carried out on data collected by the Grand Challenge Project among older adults aged ≥65 years from Selangor. Data on sociodemographic information, medical history, cognitive function and functional performance were obtained through face-to-face interviews using standardized questionnaires. Visual acuity was measured using the Early Treatment Diabetic Retinopathy Study (ETDRS) chart while hearing was assessed using pure-tone audiometry. Descriptive analysis was used to measure the prevalence of the impairments, and logistic regression analysis was used to identify the risk factors., Results: The prevalence of dual sensory impairment and hearing impairment were at 10.5% and 76.2% respectively. Multivariate logistic regression analysis revealed that participants with lower cognitive scores were associated with dual sensory impairment (odds ratio, 0.90; 95% confidence interval, 0.83-0.98), while smoking was found associated with hearing impairment (odds ratio, 6.58; 95% confidence interval, 1.51-28.65)., Conclusion: Dual sensory impairment is common among older adults in Selangor. The association between dual sensory impairment and cognitive function suggests the need to have visual and hearing screening on older adults for early detection particularly those at risk of cognitive impairment. The prevalence of hearing impairment was reported high among older adults and smokers appeared to be at higher risk of the impairment. Geriatr Gerontol Int 2020; 20: 911-916., (© 2020 Japan Geriatrics Society.)

Background: Dementia and behavioural and psychological symptoms of dementia affect older adults' care-need levels. With aging comes an increase in the incidence of sensory impairments, which promotes the development of dementia. We investigated the association between sensory impairments - visual impairment (VI), hearing impairment (HI), and dual sensory impairment (DSI), the behavioural and psychological symptoms of dementia, and dementia incidence., Methods: This was a retrospective study that used Japanese long-term care insurance certification data from 2010 to 2017 of City A. The 2190 older adults who did not have dementia in 2010 were classified into four impairment categories: VI, HI, DSI, and no sensory impairment. The incidence of dementia was examined using Kaplan-Meier survival analysis and log-rank testing. Cox proportional hazards analysis was used to investigate the risk of developing dementia associated with sensory impairments, compared to the risk for no sensory impairment. Pearson's χ 2 tests were used to compare the prevalence of behavioural and psychological symptoms of dementia among the four groups., Results: HI and DSI were associated with a higher cumulative dementia incidence compared to no sensory impairment (log-rank χ 2 = 10.42; P  < 0.001, and log-rank χ 2 = 39.92; P  < 0.001, respectively), and DSI showed higher cumulative dementia incidence than HI (log-rank χ 2 = 11.37; P  = 0.001). Cox proportional hazards analysis showed that DSI is the greatest risk factor for developing dementia among sensory impairments (hazard ratio, 1.45; 95% CI, 1.22-1.71; P < 0.001). Older adults with VI had a significantly higher prevalence of day-night reversal than the other groups., Conclusions: Our results indicate that older adults with sensory impairments have a high incidence of dementia, with DSI presenting the greatest risk. Older adults with VI were found to be more likely to have day-night reversal symptoms when dementia occurs., (© 2019 Japanese Psychogeriatric Society.)

Purpose: To estimate the prevalence, causes, and risk factors for visual impairment (VI) among children of school for hearing-impaired (HI) in Guntur district of Andhra Pradesh, India., Methods: Children between 6 and 16 years of age available in all the 12 special schools for HI were examined. Visual acuity (VA) testing, ocular motility, and examination of anterior and posterior segment for all children were done. Those having VA of less than 6/12 in better eye underwent cycloplegic refraction. For definition of VI, as per World Health Organization (WHO), VA of better eye was considered. HI was also classified as mild, moderate, severe, and profound as per WHO definitions. Examination for systemic diseases and other associated disabilities was also done., Results: In all, 402 children underwent examination. Ophthalmic abnormality was seen in 64 children with a prevalence of 15.9% [95% confidence interval (CI) 14.9%-16.8%], and VI was seen in 29 children with a prevalence of 7.2% (95% CI 4.9%-10.2%). Refractive errors [29 (7.2%)], retinitis pigmentosa (RP) [16 (4%)], and squint [8 (2%)] were the major ophthalmic abnormalities. Thirty-five (54.7%) of the abnormalities were either preventable or treatable. The major cause of VI was refractive error (18) followed by RP (5). Twenty of them (69%) with VI in this study group were treatable. Twenty-two (75.9%) children with eye problem were newly diagnosed. The only risk factor for VI was being mentally challenged (odds ratio: 5.63; 95% CI: 1.89-16.8)., Conclusion: The prevalence of ophthalmic abnormalities and VI in school for HI was high, and the majority of them were not detected so far. As most of them are easily treatable, it is highly recommended to conduct regular eye examinations in these schools., Competing Interests: None

Background: Hearing and vision problems are common in older adults. We investigated the association of self-reported sensory impairment with lifestyle factors, chronic conditions, physical functioning, quality of life and social interaction., Methods: A population-based cross-sectional study of participants of the British Regional Heart Study aged 63-85 years., Results: A total of 3981 men (82% response rate) provided data. Twenty-seven per cent (n = 1074) reported hearing impairment including being able to hear with aid (n = 482), being unable to hear (no aid) (n = 424) and being unable to hear despite aid (n = 168). Three per cent (n = 124) reported vision impairment. Not being able to hear, irrespective of use of hearing aid, was associated with poor quality of life, poor social interaction and poor physical functioning. Men who could not hear despite hearing aid were more likely to report coronary heart disease (CHD) [age-adjusted odds ratios (ORs) 1.89 (95% confidence interval 1.36-2.63)]. Vision impairment was associated with symptoms of CHD including breathlessness [OR 2.06 (1.38-3.06)] and chest pain [OR 1.58 (1.07-2.35)]. Vision impairment was also associated with poor quality of life, poor social interaction and poor physical functioning., Conclusions: Sensory impairment is associated with poor physical functioning, poor health and poor social interaction in older men. Further research is warranted on pathways underlying these associations., (© The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Falls are a geriatric syndrome which affects the physical and psychological well-being of the aged. So far, in Poland there have not been any population-based data on the prevalence of falls among the elderly. The aim of this analysis was to assess the prevalence of falls, their circumstances and consequences in the Polish population aged 65 years and older in comparison to younger respondents aged 55-59 years, and the relation of falls to visual and hearing deficits. Mean age of the 4920 elderly subjects (51.6% men) was 79.4±8.7 years. Falls in the past year were reported by 10.4% of the younger and 19.1% of the older subjects. In both groups falls occurred more frequently in women (11.9% vs. 8.7%, p=0.03 in the younger and 22.7% vs. 13.2%, p<0.001 in the older group). In the group of older subjects falls occurred most often during walking (66.7% vs. 50.7% in the group of 55-59 years old), p=0.005), while the younger more often fell while practicing sports (5.48% vs. 0.8% in the group 65+, p<0.001) and risky activities (respectively: 13.7% vs. 4.9%, p=0.002). A similar percentage of younger and older fallers reported one (44.0% and 46.1% respectively) or more falls (56.1% and 53.9%; p=0.6). The percentage of recurrent fallers grew with increasing age (Cc=0.177; p<0.001). The prevalence of injurious falls was similar in the younger and older groups (45.4% and 42.8%, p=0.53). In both genders fall-related injuries were more frequent in younger elderly (65-74 years old) and in subjects 90 years old and older. In the non-standardized analysis and after adjustment for age and gender visual and hearing impairments and its degree were associated with falls but both relations lost statistical significance after adjustment for a set of explanatory variables. Despite somewhat lower estimates, falls in older Poles are no less an important factor influencing overall health than in other populations. The higher prevalence of multiple falls should draw attention of the health-care policy makers. Sensory impairment may add to the risk of falls and should be adequately taken care of, however the priority in the future fall prevention initiative should be given to stronger factors, such as age, type of activity, overall health, cognitive function and functional status., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objectives: Relations between personality and affect are generally regarded as robust. Extraversion is closely linked to positive affect (PA), but not to negative affect (NA), whereas neuroticism is closely linked to NA, but not to PA. We argue in this work that the stress experience associated with age-related vision and hearing impairment may alter this commonly found pattern as compared with sensory unimpaired (UI) older adults., Method: We analyzed data from a sample of severely visually impaired (VI; N = 121), severely hearing impaired (HI; N = 116), and a control condition of sensory UI (grand age mean: 82 years; N = 150)., Results: Based on a structural equation modeling approach, we found that the relationship between extraversion and PA was higher in the UI as compared with the sensory impaired groups. In contrast, the strong linkage between neuroticism and NA was not affected by sensory status. Furthermore, we observed a meaningful negative relation between extraversion and NA only in the VI group., Discussion: Findings support the argument that the relationship between personality and affect deserves qualification when chronic vision and hearing impairment is present.

Purpose: To report prevalence and 5-year incidence of dual sensory impairment (DSI), and associated risk factors, in an older population., Methods: We included 2015 Blue Mountains Hearing Study participants aged ≥55 years, examined between 1997 and 1999 (baseline) and 2002 and 2004. Hearing thresholds were measured with the use of pure-tone audiometry. Visual acuity was measured with a LogMar chart while the subject wore distance glasses, if they owned a pair. DSI was defined as combined presenting visual acuity (better eye) <20/40, and PTA(0.5-4 kHz) (better ear) >25 dB HL. The incidence of DSI was considered by the use of two at-risk subpopulations: (i) participants with no sensory impairment and; (ii) with one type of sensory impairment at baseline., Results: The prevalence of DSI was 6% at baseline, increasing from 0% for ages <60 years to 26.8% for ages 80+ years (p for trend <.0001). Five-year DSI incidence was 1.6% in persons with no sensory impairment and 11.3% in those with a single sensory impairment, a 7-fold difference. Among participants with either no sensory impairment or a single sensory impairment at baseline, a significant age-related increase in incident DSI was found (p for trend <.0001 and .0004, respectively). Low education was a significant risk factor for DSI among those with no sensory impairment and those with single sensory impairment, multivariable-adjusted odds ratio (OR, 6.62; 95% confidence interval [95% CI], 1.79-24.4) and OR, 2.55 (95% CI, 1.36-4.79), respectively., Conclusions: Aging population trends and the age-related prevalence and incidence of DSI support the implementation of collaborative efforts in service provision between hearing and vision professionals. Active case-finding among older persons with single-sensory impairments may help identify those with DSI and provide timely and appropriate services., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objective: The aim of this study was to evaluate the association between vision and hearing impairment and depressive-anxiety syndrome in a large population participating in the Faenza Project, Northern Italy., Method: The study population consisted of 7389 participants not affected by dementia, 4408 (59.7%), of whom were women, mean age ± standard deviation (±SD) 71.9 (±7.7) years. Information about previous or current psychiatric symptoms, including sleeping and eating habits, non-verbal language and ability in activity of daily living was used to investigate depressive and anxiety syndrome. A semi-structured interview was administered to survey the presence of sensory impairment. Logistic regression analyses were used to evaluate the association between sensory impairment and depressive-anxiety syndrome estimating Odds ratio (OR) and 95% confidence interval (95% CI)., Results: The prevalence of vision and hearing impairment was 1.4% and 0.2%, respectively, with an increasing trend in people aged 75+ years (p < 0.001). The prevalence of depressive syndrome was higher among vision-impaired participants (20.2% vs. 9.3%, p < 0.001), especially women (22.9%) and persons aged 75+ years (22.1%). The prevalence of anxiety syndrome was higher in the hearing-impaired group (25.0% vs. 11.0%, p = 0.09). Vision-impaired participants, especially women and participants aged 75+ years had have a twofold higher probability to have depressive syndrome (OR = 2.03, 95% CI = 1.21-3.38), and hearing-impaired individuals showed an increased probability of presenting anxiety syndrome (OR = 2.71, 95% CI = 0.86-8.55), although these results were not statistically significant., Conclusion: This study's findings suggest that sensory impairment in older adults can increase their probability of experiencing depressive and anxiety syndrome. Correction of these deficits could improve the quality of life in this population.

Purpose: Visual impairment and, to a lesser extent, hearing impairment are independent predictors of reduced survival in selected studies of community-residing adults. To date, the association of severity of concurrent impairment and mortality has not been examined., Method: The National Health Interview Survey is a continuous, multistage, area probability survey of the U.S. civilian noninstitutionalized population. Mortality linkage with the National Death Index of 116,796 adult participants from 1986 to 1994 with complete impairment data was performed through 1997., Results: Findings indicate that moderate to severe concurrent hearing and visual impairment in women is associated with significantly increased risk of mortality. More modest mortality associations are evident for men and for adults with less severe impairments, irrespective of gender., Discussion: Prevention of severe visual and hearing impairment should be a national public health priority, especially given the aging of the U.S. population.

Objectives: To assess associations between age-related vision and hearing impairments and whether combined sensory losses magnify effects on health-related quality of life., Methods: Seventy-five percent of survivors (n = 2334) were reexamined at Blue Mountains Eye Study 5-year examinations and 86.3% (2015) attended hearing assessments. Visual impairment was defined as visual acuity less than 20/40 (better eye), and hearing impairment as average pure-tone air conduction threshold greater than 25 dB (500-4000 Hz, better ear)., Results: Persons with visual impairment, compared with those without visual impairment, had lower mean audiometric thresholds across all frequencies (P< or =.05). For each 1-line (5-letter) reduction in best-corrected visual acuity and presenting visual acuity, hearing loss prevalence increased by 18% and 13%, respectively. Cataract and age-related maculopathy were also associated with hearing loss (respectively, multivariate-adjusted odds ratio, 1.3 and 1.6; 95% confidence interval, 1.0-1.7 and 1.1-3.1). The association between age-related maculopathy and hearing loss was stronger at younger ages (<70 years). Combined impairments were associated with poorer health-related quality of life than were single impairments (multivariate-adjusted 36-Item Short-Form Health Survey mean physical and mental component scores; Ptrend = .001 and <.001, respectively)., Conclusions: Older persons with visual impairment were also more likely to have hearing loss in this study, which suggests that these sensory impairments could share common risk factors or biologic aging markers. Combined sensory impairments also cumulatively affect health-related quality of life.

Objective: To examine the association between the presence and severity of concurrent hearing and visual impairment (HI+VI) and morbidity., Methods: Data for adults 45 years and older were obtained from the National Health Interview Survey, 1986 to 1996 (n = 60,997). Covariate-adjusted logistic regression analyses were used to examine associations between HI+VI and five morbidity indicators: restricted activity days, bed rest days, doctor visits, hospitalizations and self-rated health., Results: Associations with morbidity indicators tended to be stronger in adults with HI+VI, and in particular, among adults with more severe HI+VI, relative to adults reporting no impairment. These associations were somewhat stronger in adults 45 to 64 years versus older adults., Discussion: HI+VI is associated with morbidity, although the strength of these associations varies across subgroups. Findings indicate that an increased focus on the provision of hearing and eye care services is required. Insurance coverage for these services should also be pursued by health policy makers.

Purpose: To determine the frequency of sensory impairments among aged care clients., Methods: We examined 188 persons aged 65-99 years being evaluated for aged care services at a geriatric assessment center, west of Sydney, Australia. Visual acuity was measured using a LogMAR chart. Visual impairment was defined in the better eye: mild < 20/40 to > or = 20/80, moderate < 20/80 to > or = 20/200, and severe < 20/200. Hearing function was assessed by portable pure-tone air-conduction audiometry. Hearing loss was defined using average hearing thresholds in the better ear: mild > 25 to < or = 40 decibels (dB), moderate > 40 to < or = 60dB, and severe > 60dB., Results: Vision, hearing, or both were randomly tested in 96, 93, and 49 aged care clients, respectively. Vision impairment was found in 30.2% of clients. Distance vision could be improved with pinhole in 16.7% of 84 clients with presenting VA < 20/20. Moderate to severe hearing loss was present in 50.5%. Combined sensory impairment was detected in 22.5% of persons having both tests. The age-standardized proportions with vision impairment was 25.6%, higher than the rate (17.4%) found in the Blue Mountains Eye Study (BMES) community population, but lower than the 37.7% prevalence reported from the BMES nursing home sample. Hearing impairment was also more common in aged care clients (28.1% vs 17.5%)., Conclusions: This study suggests a high prevalence of sensory impairment among older persons transitioning from independent community living to institutionalized care.