The Impact of Self-Reported Vision and Hearing Impairment on Health Expectancy

OBJECTIVES Vision and hearing impairment may impact both life expectancy (LE) and health expectancy, that is, duration of life with and without health problems, among older adults. We examined the impact of self-reported vision and hearing impairment on years of life with and without limitation in physical function and in activities of daily living (ADLs). DESIGN Life table analysis, using a nationally representative longitudinal survey of community-dwelling older adults aged 60 years or older, Panel on Health and Ageing of Singaporean Elderly. SETTING Singapore. PARTICIPANTS Survey participants (n = 3452) who were interviewed in 2009 and followed up in 2011-2012 and 2015. MEASUREMENTS Participants reporting difficulty with any of nine tasks involving upper or lower extremities were considered to have a limitation in physical function. Those reporting health-related difficulty with any of six basic ADLs or seven instrumental ADLs were considered to have a limitation in ADLs. We used the multistate life table method with a microsimulation approach to estimate health expectancy, considering self-reported sensory impairment status as time varying. RESULTS Either or both impairments, vs neither, were associated with less years without limitation in physical function and in ADLs and more years with limitation in physical function and in ADLs, with the greatest impact on health expectancy among those with both impairments, who also had the lowest LE. For example, at age 60, those with both impairments, vs neither, could expect not only shorter LE (4.2 [95% confidence interval [CI] = 1.9-5.7] less years; 20.7 [95% CI = 18.9-22.5] vs 24.9 [95% CI = 23.8-26.0]) but also more years of life with limitations in physical function (3.3 [95% CI = .9-5.8] more years; 12.8 [95% CI = 10.7-14.8] [about 61.7% of LE] vs 9.5 [95% CI = 8.4-10.5] [about 38.0% of LE]). CONCLUSION Timely and appropriate management of vision and hearing impairment, especially when coexisting, among older adults has the potential to reduce the years of life they live with limitation in physical function and in ADLs.