Visual and hearing impairment and retirement in older adults: a population-based cohort study

Objective Impaired vision and hearing are common among older adults and have been shown to reduce functional independence and to reduce quality of life. This cohort study investigated the cross-sectional and temporal associations between objectively measured dual sensory impairment (DSI) and retirement from employment. Study design 2409 Blue Mountains Eye Study participants aged 55+ years at baseline were included for analyses. Main outcome measures Visual impairment was defined as visual acuity less than 20/40 (better eye), and hearing impairment as average pure-tone air conduction threshold >25 dB HL (500–4000 Hz, better ear). Employment status was questioned at each examination over 10 years. Results At baseline, 650 (27.0%) were employed and 1759 (73.0%) were retired. Cross-sectional analysis showed that participants with moderate to severe hearing loss, compared with those with normal hearing, had greater odds of being retired (multivariable-adjusted OR 1.96; 95% CI 1.05–3.66). Participants presenting with concurrent visual impairment and moderate to severe hearing loss versus participants with no sensory loss had a significantly lower mean retirement age, 57.1 versus 58.7 years (multivariable-adjusted p-value = 0.04). Participants with any hearing loss at baseline had significantly higher odds of being retired by the 10-year follow-up (age-sex adjusted OR 1.82; 95% CI 1.00–3.30); this became marginally non-significant after adjusting for all other covariates (multivariable-adjusted OR 1.74; 95% CI 0.95–3.17). No associations were observed between DSI and the incidence of retirement. Conclusions Sensory impairment in older adults was independently associated with the decision to retire.