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  • Link Between Serious Sensory Deficit and Cognitive/Functional Difficulty

    By Lynda Seminara
    Selected By: Stephen D. McLeod, MD
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    Journal Highlights

    Ophthalmology, April 2018

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    Fuller et al. estimated the nationwide prevalence of self-reported serious vision impairment, serious hearing impairment, and serious dual sensory impairment (serious vision plus serious hear­ing impairment) and examined their association with self-report­ed difficulties in cognition, inde­pendent living, self-care, and ambulation. They found that any sensory impair­ment portends greater cognitive and functional decline and that self-reported sensory impairments increase with age.

    Study data were derived from the 2011-2015 sample of the American Community Survey of the U.S. Census Bureau (7,210,535 individuals ≥ 45 years of age). Main outcome measures were self-reported difficulties with cognition, independent living, self-care, and ambulation. Using a weighted sample, the authors calculated descrip­tive statistics for each of the 4 mutually exclusive sensory impairment catego­ries: no sensory impairment, serious vision impairment, serious hearing impairment, and serious dual sensory impairment. Adjusted odds ratios of the unweighted sample were used to measure the magnitude of associations between sensory impairment status and related difficulties.

    Findings showed that, among indi­viduals aged ≥ 45 years, the estimated nationwide prevalence of self-reported serious vision impairment alone, serious hearing impairment alone, and serious dual sensory impairment was 2.8%, 6.0%, and 1.6%, respectively. The prevalence of each sensory impairment increased substantially with age. For example, the prevalence of serious dual sensory impairment increased from 0.7% for ages 45-64 to 1.8% for ages 65-79 to 7.6% for ages ≥ 80.

    With respect to race and ethnicity,the incidence of impairment was highest among Native Americans, including those in Alaska (serious vision impair­ment, 4.8%; serious hearing impair­ment, 8.5%; and serious dual sensory impairment, 3.7%) and lowest among Asians (1.7%, 3.47%, and 1.04%, re­spectively, for the same categories).

    For all age groups, those who noted serious dual sensory impairment were more likely than those with no sensory impairment to report problems with cognition, independent living, self-care, and ambulation. Cognitive and func­tional difficulties were greatest in those with serious dual sensory impairment. Serious vision impairment alone was associated with more cognitive and functional difficulties than serious hearing impairment alone.

    Thus, the national prevalence of self-reported serious sensory impairment grows with age and has disparate distribution among racial and ethnicgroups. According to the Census Bureau, the subpopulation ≥ 65 years of age is expected to continue growing, from 43.1 million in 2012 to 83.7 million by 2050. Targeting visual impairment in a preventive manner may reduce the burden of functional limitations and improve the ability to live independently.

    The original article can be found here.