Estimating the years lived with and without age-related sensory impairment

Background: The aim of this study was to estimate the expected years lived with hearing impairment, vision impairment, and dual sensory impairment among older adults. Methods: A total of 4,160 adults (45.1% men) from two Australian community based studies were followed for up to 16 years (average 8.9 years). Hearing impairment was defined by a pure-tone average (500-4000 Hz) greater than 25 dB in the better ear. Vision impairment was defined by presenting distance visual acuity worse than 6/12 (20/40). Postliminary analyses were also conducted for moderate levels of sensory impairment. Dual sensory impairment was defined by concurrent hearing and vision impairment. Multistate Markov models were used to calculate sensory life expectancies based on transition probabilities between health states (no sensory impairment, sensory impairment, and death). Results: Based on thresholds for mild impairment, men aged 65 had a total life expectancy of 19.4 years, and were estimated to live for 10.4 years (95% confidence interval [CI]: 9.1, 11.7) with hearing impairment, 2.8 years (95% CI: 2.4, 3.2) with vision impairment, and 2.2 years (95% CI: 1.8, 2.6) with dual sensory impairment. Women aged 65 had a total life expectancy of 23.2 years, and were estimated to live for 12.9 years (95% CI: 11.9, 13.9) with hearing impairment, 3.9 years (95% CI: 3.4, 4.4) with vision impairment, and 3.2 years (95% CI: 2.7, 3.7) with dual sensory impairment. Conclusions: In addition to being highly prevalent, hearing and vision impairment affect older adults for substantial periods of their remaining life. Given their broad ranging impacts on health and well-being, sensory impairments are ideal targets for strategies to compress morbidity in late life.