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Bei Bei Chen, Nazlee Zebardast, Frank Lin, Pradeep Ramulu, David Friedman; The Impact of Visual Field Loss and Hearing Loss on Social Function. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5336.
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To evaluate the independent and combined impact of visual field loss from glaucoma and hearing loss on measures of social function and well-being.
137 subjects (60-80 years old) with binocular presenting visual acuity (VA) of 20/40 or better were recruited from patients followed for glaucoma or suspect glaucoma at the Wilmer Eye Institute. Visual field (VF) impairment was defined as a better-eye VF mean deviation (MD) of -5 decibels (dB) or worse. Hearing impairment was defined as better-ear pure-tone average hearing threshold of 25 dB or worse across 4 frequencies (0.5, 1, 2 and 4 kHz). Subjects were divided into 4 groups: no impairment (N=53), visual impairment (VI; N=20), hearing impairment (HI; N=39) and combined vision and hearing impairment (CVHI; N=25). Self-reported hearing-related social handicap and communication difficulty were assessed using the Hearing Handicap Inventory for the Elderly (HHIE) and the Quantified Denver Scale of Communication Function (QDS) respectively. Patients’ sense of social isolation and loneliness were assessed using the Social Network Index (SNI) and the UCLA Loneliness Scale respectively. Multivariable regression analyses, adjusted for demographic factors, were used to assess the impact of sensory impairment on metrics of social function using the group with no impairment as reference.
Group differences were identified in age (p<0.05) but not in gender, race, education, cognitive ability or comorbid illness. Moderate hearing-related social handicap (higher HHIE score) was more common amongst subjects with HI (odds ratio [OR]=8.0, p<0.01) and CVHI (OR=8.2, p<0.01) as compared to individuals with no impairment. Subjects with HI (OR=6.5, p=0.01) and CVHI (OR=5.6, p=0.03) were also more likely to report communication difficulty (higher QDS score). Sensory impairment was not associated with an increase in sense of loneliness as judged by the UCLA loneliness scale. Subjects with VI (OR=3.2, p=0.05), but not subjects with HI or CVHI, were more likely to have significantly lower network diversity (lower SNI score) when compared to subjects with no impairment.
VI, HI and CVHI all demonstrated a negative impact on at least one measure of social function. Detection of vision and hearing impairment may be of particular importance in improving social well-being in the elderly.
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