Subjective vision and hearing impairment and falls among community-dwelling adults: a prospective study in the Survey of Health, Ageing and Retirement in Europe (SHARE)

Purpose To investigate the association between vision and hearing impairment and falls in community-dwelling adults aged >= 50 years. Methods This is a prospective study on 50,986 participants assessed in Waves 6 and 7 of the Survey of Health, Ageing and Retirement in Europe. At baseline, we recorded socio-demographic data, clinical factors and self-reported vision and hearing impairment. We classified participants as having good vision and hearing, impaired vision, impaired hearing or impaired vision and hearing. We recorded falls in the six months prior to the baseline and 2-year follow-up interviews. The cross-sectional and longitudinal associations between vision and hearing impairment categories and falls were analysed by binary logistic regression models; odds ratios (OR) and 95% confidence intervals (CI) were calculated. All analyses were adjusted for socio-demographic and clinical factors. Results Mean age was 67.1 years (range 50-102). At baseline, participants with impaired vision, impaired hearing, and impaired vision and hearing had an increased falls risk (OR (95% CI)) of 1.34 (1.22-1.49), 1.34 (1.20-1.50) and 1.67 (1.50-1.87), respectively, compared to those with good vision and hearing (all p < 0.001). At follow-up, participants with impaired vision, without or with impaired hearing, had an increased falls risk of 1.19 (1.08-1.31) and 1.33 (1.20-1.49), respectively, compared to those with good vision and hearing (both p < 0.001); hearing impairment was longitudinally associated with falls in middle-aged women. Conclusion Vision impairment was cross-sectionally and longitudinally associated with an increased falls risk. This risk was highest in adults with dual sensory impairment. Key summary pointsAim To investigate the relationship between self-reported vision and hearing impairment and falls risk in community-dwelling adults aged >= 50 years in the cross-national Survey of Health, Ageing and Retirement in Europe (SHARE). Findings Self-reported vision impairment, versus no impairment, was cross-sectionally and longitudinally associated with an increased falls risk in adults, independent of age, sex, self-rated health, co-morbidities and medications. The risk was highest when vision and hearing impairment coincided. Message Simple questions on self-reported sensory impairment can be used to assess the risk of falls in adults.