The associations between self-rated vision and hearing and functional status in middle age

doi:10.1016/S0161-6420(99)90082-9

Ophthalmology

Volume 106, Issue 2, 1 February 1999, Pages 401-405

https://doi.org/10.1016/S0161-6420(99)90082-9 Get rights and content

Abstract

Objectives

To describe the associations between self-reported visual and hearing impairment and an index of global functional status among community-dwelling, middle-aged Americans.

Design

Cross-sectional.

Participants

A total of 9744 U.S. community-dwelling persons 51 to 61 years of age participated.

Methods

Multivariate analyses of functional status based on cross-sectional data from Wave I (1992) of the Health and Retirement Study (HRS), controlling for demographic and socioeconomic status, common chronic medical conditions, and general health status, were performed.

Main outcome measure

A global index of functional status based on self-reported limitations in 17 activities was measured.

Results

Approximately 3% of respondents in the HRS rated their vision or hearing as poor. Even after controlling for demographic factors, socioeconomic status, medical conditions, and general health status, limitations in both vision and hearing were independently correlated with worse functional status. In addition, controlling for income, wealth, and education reduced the strength of the associations between vision and hearing impairment and function, but did not eliminate them. The magnitude of effect of poor vision exceeded all medical conditions except stroke.

Conclusions

Visual and hearing impairment appear to have a significant relationship with overall functional status, among even community-dwelling, middle-aged Americans and even after controlling for general health status, medical comorbidities, and socioeconomic status.

Section snippets

Data overview

This study uses data from Wave I (1992) of the Health and Retirement Survey (HRS), funded by the National Institute on Aging.14 The HRS is a national probability sample of 12,654 men and women 51 to 61 years of age in 1992 and their spouses in 7700 households with a 2:1 oversampling of black and Hispanic persons. The overall response rate was 81%. Our analyses were restricted to the 9744 respondents and spouses between 51 and 61 years of age. Approximately 2804 spouses whose ages were outside

Results

Table 1 presents the demographic and health characteristics of the study population. Table 2 illustrates the distribution of responses to the vision and hearing questions. While most respondents reported excellent to good vision or hearing, only 2% to 3% rated their vision or hearing as being poor, with approximately 12% rating their senses as fair or poor.

Table 3, Table 4 show the significant relationship between decrements in hearing or vision on functioning and well-being. The two-limit

Discussion

Reports from numerous authors analyzing many different datasets have clearly shown the unique and significant impact of decreased vision and self-rated quality of vision on diminishing functional status and well-being, as measured by a range of instruments.1, 2, 3, 4, 5, 6, 7, 8 Studies examining the effect of hearing have similarly identified a significant effect of hearing loss, whether self-reported or measured with audiometry.6, 9, 10, 11, 12, 13 Many studies that have examined both hearing

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Cited by (27)

Psychological distress and well-being among sensory impaired individuals during COVID-19 lockdown measures
2023, Annals of Epidemiology
Hearing and vision impairment are prevalent chronic conditions associated with poorer mental health. Limitations of in-person contacts during COVID-19-related lockdown measures may affect those with sensory impairments more severely exacerbating mental health problems. We aimed to determine whether hearing and/or visual impairment were associated with more psychological distress during a time of lockdown measures in Spring/Summer 2020 in Wisconsin.
We included 1341(64% women, aged 20–92 years) Survey of the Health of Wisconsin COVID-19 survey participants (May 2020–July,2020). We assessed self-reported current mental health and well-being and vision and hearing impairment. Logistic regression models with sensory impairments as determinants and mental health outcomes were adjusted for age, gender, race, education, heart disease, hypertension, hyperlipidemia, and diabetes.
Vision impairment was associated with increased odds of generalized anxiety disorder (odds ratio = 2.10; 95% confidence interval = 1.32–3.29) and depressive symptoms (2.57;1.58–4.11), greater likelihood to report loneliness (1.65;1.00–2.64) and hopelessness (1.45;1.01–2.08). Hearing impaired individuals reported more loneliness (1.80;1.05–2.98) and hopelessness (1.42;0.99–2.03). Exploratory analyses revealed that sensory impaired individuals less often chose walking as a coping strategy during the pandemic.
Individuals with sensory impairment may represent a particularly vulnerable population during the COVID-19 pandemic. Future research should determine underlying reasons and interventions to mitigate this populations’ disadvantages.
Visual impairment at baseline is associated with future poor physical functioning among middle-aged women: The Study of Women's Health Across the Nation, Michigan Site
2017, Maturitas
Citation Excerpt :
This latter finding could be due to visual impairment being an important risk factor affecting physical functioning among women not already compromised in functioning by obesity or other factors, including comorbidities and pain, that play a role in worsening physical functioning among obese women. A previous study by Lee et al. reported 20–50% decline in self-reported measures of functional status among a middle aged population with poor self-reported vision [24]. Similar to Lee et al., our findings also support an association of poorer physical functioning among midlife women with visual impairment.
Emerging evidence suggests that the prevalence rates of poor functioning and of disability are increasing among middle-aged individuals. Visual impairment is associated with poor functioning among older adults but little is known about the impact of vision on functioning during midlife. The objective of this study was to assess the impact of visual impairment on future physical functioning among middle-aged women.
In this longitudinal study, the sample consisted of 483 women aged 42 to 56 years, from the Michigan site of the Study of Women’s Health Across the Nation.
At baseline, distance and near vision were measured using a Titmus vision screener. Visual impairment was defined as visual acuity worse than 20/40. Physical functioning was measured up to 10 years later using performance-based measures, including a 40-foot timed walk, timed stair climb and forward reach.
Women with impaired distance vision at baseline had 2.81 centimeters less forward reach distance (95% confidence interval (CI): −4.19, −1.42) and 4.26 s longer stair climb time (95% CI: 2.73, 5.79) at follow-up than women without impaired distance vision. Women with impaired near vision also had less forward reach distance (2.26 centimeters, 95% CI: −3.30, −1.21) than those without impaired near vision.
Among middle-aged women, visual impairment is a marker of poor physical functioning. Routine eye testing and vision correction may help improve physical functioning among midlife individuals.
Associations of Eye Diseases and Symptoms with Self-Reported Physical and Mental Health
2009, American Journal of Ophthalmology
Citation Excerpt :
The sample included both younger and older adults with a large mix of comorbid medical conditions and systemic symptoms. Prior studies were limited to older Americans or to patients enrolled in an ongoing study.6–8 The results of this study are quite similar to those of the earlier studies and thus buttresses our understanding of the critical role that visual symptoms play in general HRQOL.
To study the associations of eye diseases and visual symptoms with the most widely used health-related quality-of-life (HRQOL) generic profile measure.
HRQOL was assessed using the short form-36 (SF-36) version 1 survey administered to a sample of patients receiving care provided by a physician group practice association.
Eye diseases, ocular symptoms, and general health were assessed in a sample of patients from 48 physician groups. A total of 18,480 surveys were mailed out and 7,093 returned; 5,021 of these had complete data. Multiple linear regression models were used to examine the decrements in self-reported physical and mental health associated with eye diseases and symptoms, including trouble seeing and blurred vision.
Nine percent of the respondents had cataracts, 2% had age-related macular degeneration, 2% glaucoma, 8% blurred vision, and 13% trouble seeing. Trouble seeing and blurred vision both had statistically unique associations with worse scores on the SF-36 mental health summary score. Only trouble seeing had a significant association with the SF-36 physical health summary score. While these ocular symptoms were significantly associated with SF-36 scores, having an eye disease (cataracts, glaucoma, and macular degeneration) was not, after adjusting for other variables in the model.
Our results suggest an important link between visual symptoms and general HRQOL. The study extends the findings of prior research to show that both trouble seeing and blurred vision have independent, measurable associations with HRQOL, while the presence of specific eye diseases may not.
Parents' and Offspring's Perceptions of Change and Continuity when Parents Experience the Transition to Old Age
2007, Advances in Life Course Research
Most parents and children are fortunate to share several decades of the life course when both parties are healthy adults. When parents reach the transition to old age, however, they typically experience health declines and both parties must adjust to changes in the relationship. The sample included older adults (aged 70+) suffering vision loss, hearing loss, or seeking general health care and a grown son or daughter (N=121 dyads, 242 individuals). Aging parents also suffered common health problems (e.g., hypertension, arthritis). Parents and offspring provided open-ended descriptions of changes and continuities in their relationship. Although prior studies link parental health declines to intergenerational ambivalence, most parents and offspring in this study mentioned positive changes in the relationship in recent years, regardless of parental health. Multilevel models revealed that perceptions of changes in parental health or receipt of support were associated with objective indicators of parental health. Findings suggest offspring's views of the relationship converge with parents’ when parents reach the transition to old age and show physical signs of aging.
Psychosomatic status affects the relationship between subjective hearing difficulties and the results of audiometry
2004, Journal of Clinical Epidemiology
Subjective hearing difficulties are often used as a surrogate to audiometry in health check-up, although its effectiveness has not been tested in healthy workers. We conducted a study to test the usefulness of self-reported hearing difficulties for screening hearing impairment among healthy workers by comparing the results with those of audiometry.
This was a cross-sectional observational study. A sample of 12,495 healthy workers in Japan without excess noise exposure was recruited at regular health check-up. Audiometry was conducted after self-administered questionnaire asking symptoms including hearing difficulties. The results were compared to those of audiometry as the gold standard.
Overall prevalence of hearing impairment was 4.6% among the population. Subjective hearing difficulties showed 0.21 of sensitivity, 0.95 of specificity, and 0.93 of accordance against audiometry. When limited to those with more than two psychosomatic symptoms, however, the corresponding numbers were 0.43, 0.85, and 0.83.
The assessment of subjective hearing difficulty may not be able to replace audiometry, but may be useful to detect psychosocial problems of hearing in the workplace.
Self-reported dual sensory impairment and related factors: a European population-based cross-sectional survey
2023, British Journal of Ophthalmology

View all citing articles on Scopus

^☆: Supported by National Institute on Aging Grant 5PO-AG08291 and Research to Prevent Blindness, Inc., New York, New York.

¹: The authors have no propriety interests in any aspect of this study.

View full text

The associations between self-rated vision and hearing and functional status in middle age1☆,

Abstract

Objectives

Design

Participants

Methods

Main outcome measure

Results

Conclusions

Section snippets

Data overview

Results

Discussion

Ophthalmology

Ophthalmology

J Clin Epidemiol

J Econometrics

Impaired vision and hip fracture. The Framingham Study

J Am Geriatr Soc

Functional associations of “trouble seeing”

J Gen Intern Med

Association of visual impairment with mobility and physical function

J Am Geriatr Soc

Quality of life and cataractsa review of patient-centered studies of cataract surgery outcomes

Ophthalmic Surg

The relationship of vision and hearing impairment to one-year mortality and functional decline

J Aging Health

Measurement of visual functioning of health-related quality of life in eye disease and cataract surgery

Brief cognitive screening of the elderlya comparison of the Mini-Mental State Examination (MMSE), Abbreviated Mental Test (AMT) and Mental Status Questionnaire (MSQ)

Psychol Med

Association between hearing impairment and the quality of life of elderly individuals

J Am Geriatr Soc

The associations between self-rated vision and hearing and functional status in middle age¹☆,