Association Between Sensory Loss and Falls Among Middle-Aged and Older Chinese Population: Cross-Sectional and Longitudinal Analyses

Abstract

Introduction: Previous studies have suggested that sensory loss is linked to falls. However, most of these studies were cross-sectional designed, focused on single sensory loss, and were conducted in developed countries with mixed results. The current study aims to investigate the longitudinal relationship between hearing loss (HL), vision loss (VL) and dual sensory loss (DSL) with falls among middle-aged and older Chinese population over 7 years.Methods: The data was obtained from the China Health and Retirement Longitudinal Survey (CHARLS). In total, 7,623 Chinese older adults aged over 45 were included at baseline 2011 in this study. Self-reported falls and HL/VL/DSL were accepted. Other confounding variables included age, sex, BMI, educational level, marital status, various physical disorders and lifestyles. The impact of baseline sensory status on baseline prevalence of falls and incident falls over 7 years were assessed using logistic regression analyses. A logistic mixed model was used to assess the association between time-varying sensory loss with incident falls over 7 years after adjusted with multi-confounding factors.Results: Single and dual sensory loss groups had significantly higher prevalence of falls compared to no sensory loss (NSL) group (DSL: 22.4%, HL: 17.4%, VL: 15.7%, NSL: 12.3%). Baseline HL (OR: 1.503, 95% CI: 1.240–1.820), VL (OR: 1.330, 95% CI: 1.075–1.646) and DSL (OR: 2.061, 95% CI: 1.768–2.404) were significantly associated with prevalence of falls. For longitudinal observation over 7 years, baseline HL/DSL and persistence of all types of sensory loss were associated with incidence of falls. Time-varying HL (OR: 1.203, 95% CI: 1.070–1.354) and DSL (OR: 1.479, 95% CI: 1.343–1.629) were associated with incident falls after adjusted with multi-confounders, while VL was not.Conclusion: HL and DSL are significantly associated with both onset and increased incidence of falls over 7 year's observation in middle-aged and elderly Chinese population. Persistence or amelioration of sensory loss status could exert divergent influences on incidence of falls, which should be considered in the development of falls-prevention public health policies for aging population.

Do Sensory Impairments Portend Cognitive Decline in Older Chinese Adults? Longitudinal Evidence from a Nationally Representative Survey, 2011–2018

“…First, data on sensory impairment were obtained from respondents’ self-reports. Although this method has been used in numerous population-based studies [ 8 , 18 , 25 , 26 , 27 , 28 ], possible misclassification of sensory loss status might lead to bias. Participants were asked to rate their vision and hearing statuses with their assistive devices (e.g., hearing aids, glasses, or portable magnifiers) if they used them, the sufficiency of correction by these aids was not assessed.…”

“…Similarly, for HI assessment, the question was: “Is your hearing excellent, very good, good, fair or poor (with a hearing aid if the participant frequently uses it in daily life, or without if the participant doesn’t)?” A response of fair/poor hearing was identified as HI. Such assessment of SI has been widely used in previous CHARLS-related studies [ 18 , 25 , 26 , 27 , 28 ]. DSI refers to participants with both VI and HI.…”

Associations of Household Solid Fuel Use With Falls and Fall-Related Injuries in Middle-Aged and Older Population in China: A Cohort Study

“…Educational level was categorized as "illiterate" (no formal education illiterate) and "primary school and above" (did not finish primary school but capable of reading or writing, home school, elementary school, middle school, high school, vocational school, Two/Three Year College/Associate degree, Four Year College/Bachelor's degree, Master's degree, Doctoral degree/ Ph.D.) [23,26]. Participants who were separated, divorced, widowed or never married were coded as "living alone" group, while those who were married or partnered were coded as "living with partner" group [27]. Self-reported family economic status "very high" and "relatively high" were combined as "good", "average" still is "fair", whereas "relatively poor" and "poor" were combined as "poor" [28].…”

Sensory impairments and subjective well-being status in middle-aged and older Chinese population: Cross-sectional and longitudinal analyses of a nationally representative survey

“…More importantly, elderly Chinese are likely to neglect SIs and consequent problems owing to the traditional attitudes regarding SIs as normal parts of aging life, which might further contribute to the higher prevalence of SIs in China than in some western countries (20). SIs have been noticed to have certain influences on adverse health consequences in middle-aged and older Chinese population (21)(22)(23). Allowing for the specific cultural background, social institution, and health system in mainland China, the aim of the present study is to address the research gap of the associations between SIs with LE/LS/SRH among middle-aged and older Chinese population using crosssectional and longitudinal data over 8 years of observation.…”