Clinical Question

Does impairment in vision, hearing, or both increase the risk of falls or death in older adults?

Evidence-Based Answer

Dual sensory (vision and hearing) impairment in patients older than 65 years may be associated with an increased mortality risk.

Evidence Summary

A 2020 prospective cohort study (n = 37,076) examined the association between sensory impairment and all-cause mortality.¹ Patients were 70 years and older, registered in the Chinese Longitudinal Healthy Longevity Survey, and were followed from 1998 to 2019. Patients were assigned to one of four categories, based on a 1-m visual acuity test and a conversational self-report assessment: vision impairment, hearing impairment, dual sensory impairment, or no impairment. The primary outcome was the age at death, which was reported by a family interview. Compared with nonimpaired individuals, there was a higher risk of death in the vision-impaired group (hazard ratio [HR] = 1.2; 95% CI, 1.15 to 1.24), the hearing-impaired group (HR = 1.3; 95% CI, 1.2 to 1.3), and the dual sensory–impaired group (HR = 1.5; 95% CI, 1.4 to 1.5). However, the study was limited by the subjective definition of sensory impairment, possible confounding of cognitive impairment (which was not assessed), and subjective reporting for deaths that occurred at home.