Association between hearing and vision impairments in older adults

To determine which, if any, vision variables are associated with moderate bilateral hearing loss in an elderly population.

Four hundred and forty-six subjects completed a hearing screening in conjunction with measurements on a variety of vision tests including high contrast acuity, low contrast acuity measured under a variety of lighting conditions, contrast sensitivity, stereopsis, and colour vision. Logistic regression analyses were used to assess the relationship between various vision variables and hearing impairment while controlling for demographic and other co-morbid conditions.

In this sample of older adults with a mean age of 79.9 years, 5.4% of individuals were moderately visually impaired (binocular high contrast VA worse than 0.54 logMAR, Snellen equivalent 6/21 or 20/70) and 12.8% were moderately bilaterally hearing impaired (hearing none of the 40 dB tones at 500, 2000 or 4000 Hz in either ear). Three measures of low contrast acuity, but not high contrast acuity or other vision measures, were significantly associated with hearing loss when controlling for age, cataract surgery history, glaucoma history and self reported stroke, all of which were significantly associated with hearing loss, although the association of glaucoma with hearing loss was negative.

Poorer vision for low contrast targets was associated with an increased risk of hearing impairment in older adults. Audiologists and optometrists should enquire about the other sense in cases in which a deficit is measured as individuals with dual sensory loss are at a marked disadvantage in daily life.