Current estimates of dual sensory impairment among older adults are as high as 21%. However, the lack of established empirical relationships between behavioral risk factors (i.e., smoking, alcohol consumption, lack of exercise, and obesity), and vision, hearing and dual sensory impairments has seriously limited health promotion and disease prevention efforts. Furthermore, the prevalence of vision, hearing and dual sensory impairments is greater among minority elders. For example, compared to Whites, African-Americans have a higher rate of legal blindness and glaucoma as well as poorer lowfrequency hearing. However, research on dual impairment among minority elders has been seriously overlooked although this population is at a heightened risk for chronic health problems and resultant disability.
The aim of the project is to systematically examine and identify the prevalence of and behavioral risk factors for vision, hearing, and dual sensory impairments among White, Black and Hispanic adults aged 50 and over in the United States. Racial/ethnic and gender differences in the prevalence and incidence of vision, hearing and dual sensory impairments were examined. The research provides both the scientific community and the aging network with yet unavailable information for understanding racial/ethnic differences in how modifiable health behaviors are linked to the development of vision, hearing and dual sensory impairment in later life. Such information will help promote visual and auditory health by providing recommendations for behavioral prevention.
The study makes use of existing information from two national panel data sets, the Health and Retirement Survey (HRS) and the Assets and Health Dynamics Among the Oldest Old (AHEAD). These surveys contain information on over 20,000 individuals and their spouses regarding health status and transitions, health behavior, health care utilization, family structure, and income. Interview questions also specifically addressed vision, hearing, and socioeconomic/demographic characteristics. These data include a large number of people from minority populations, allowing for the investigation of racial/ethnic differences in prevalence, incidence and risk factors related to vision, hearing and dual sensory impairments over time.
Sensory impairment status was obtained with the following two questions: "With your glasses/contact lenses or hearing aid, is your eyesight/hearing excellent, very good, good, fair or poor?" Respondents were classified as nonimpaired, singly vision or hearing impaired, or dual impaired based on these items.
Among U.S. preretirees (ages 51 to 61), 11% reported some degree of vision impairment and 13% reported some degree of hearing impairment in 1992. The percentage of vision impairment increased from 11% to 18%, while there was a 3% increase in hearing impairment over the 8 years of the HRS study. The prevalence of dual impairment among preretirees was 4% at the baseline in 1992, rising to 5% after eight years.
More than 27% of the older adults (i.e., age 70 and over) reported some degree of vision impairment and 27% reported some degree of hearing impairment in 1993. Over the five-year course of the study, vision impairment increased to 33%, while hearing impairment rose to 34%. Among older adults, 12% were dually impaired in both vision and hearing in 1993. This proportion rose to 17% after five years.
Behavioral Risk Factors - A number of behavioral and lifestyle factors were significantly related to the risk of single and dual sensory loss among preretirees and older adults, primarily alcohol consumption and use of tobacco. Light and moderate alcohol consumption was found to be protective of vision, hearing and dual sensory impairment concurrently and over time. Current and past smoking were found to increase the risk of vision, hearing and dual sensory impairment concurrently and over time. The effect was most pronounced among heavy smokers. In terms of body weight among preretirees, being obese increased the risk of hearing and dual impairment concurrently. But obesity was not related to sensory loss in the older adult population, while being underweight reduced the risk of sensory loss in this group. Light physical activity reduced the risk of vision and dual impairments, while frequent vigorous exercise was related to vision, hearing and dual sensory loss among preretirees.
Health and Sociodemographic Factors - Circulatory health conditions (i.e., hypertension, diabetes, and heart disease) were found to be risk factors for vision, hearing and dual sensory impairments. Gender comparisons revealed that females had lower risk of vision, hearing and dual sensory impairments. Being married was negatively related to vision impairment among preretirees, however marital status was not a significant predictor of sensory loss among the older adults. Blacks and Hispanics have higher risk of vision impairment, but a lower risk of hearing impairment compared to Whites. The increased risk for vision loss among Hispanics was primarily among preretirees. Higher education and income levels were found to be protective of sensory loss in later life. Lower status occupations (i.e., unskilled work) were related to sensory loss among the preretirees and the oldest-old. Finally, being older increased the odds of sensory loss in general. Not only was the prevalence of vision, hearing and dual sensory loss higher among persons 70 and older in comparison to preretirees, but also among older adults, each additional year of age increased the risk of sensory loss approximately 2% to 8%.
This research provides the scientific community and the aging population with previously unavailable information of how modifiable health behaviors are linked to the development of vision, hearing and dual sensory impairment in later life. These results have the potential to help promote visual and auditory health by providing counsel for behavioral prevention (i.e., reducing the use of tobacco and heavy alcohol consumption, supporting moderate use of alcohol and increasing the prevalence of physical activity and healthy bodyweight).
The final report was submitted to the M. C. Adams Charitable Trust in March 2003.
Brennan, M. (2005). Sensory impairment, vision and hearing. In C. B. Fisher & R. M. Lerner (Eds.), Encyclopedia of applied developmental science, Vol. II (pp. 984-986). Thousand Oaks: Sage.
Brennan, M., & Bally, S. J. (2007). Psychosocial adaptations to dual sensory loss in middle and late adulthood. Trends in Amplification, 11(4), 281-300.
Brennan, M., Horowitz, A., & Su, Y. (2005). Dual sensory loss and its impact on everyday competence. The Gerontologist, 45, 337-346.
Brennan, M., Su, Y., & Horowitz, A. (2006). The longitudinal associations between dual sensory impairment and everyday competence among older adults. Journal of Rehabilitation Research and Development, 43 (6), 777-792.
Brennan, M. (2003). Impairment of both vision and hearing among older adults: Prevalence and impact on quality of life. Generations, 27 (1), 52-56.
Su,Y., & Brennan, M. (2003). Behavioral risk factors and dual sensory impairment. Final report submitted to the M. C. Adams Charitable Trust. New York: Arlene R. Gordon Research Institute of Lighthouse International.
Su,Y., & Brennan, M. (2005). Behavioral risk factors and dual sensory impairment. Manuscript under review.
Brennan, M. (2003, August). Sensory impairment, race and cognitive function in older adults. Poster session presented at the annual convention of the American Psychological Association, Toronto, Ontario, CA.
Brennan, M., & Su, Y. (2003, November). Incidence and prevalence of dual sensory impairment in adults 70 years and older over 5 years. Poster session presented at the annual scientific meeting of the Gerontological Society of America, San Diego, CA.
Su, Y., & Brennan, M. (2002, November). Behavioral risk factors of dual sensory impairment in older adults. Poster session presented at the annual scientific meeting of The Gerontological Society of America, Boston, MA.
Investigators: Ya-Ping Su, PhD, Co-Principal Investigator
Mark Brennan, PhD, Co-Principal Investigator
Funded by: M. C. Adams Charitable Trust
Project Period: 10/1/01 - 3/30/03