Longitudinal Associations Between Hearing and Visual Function and ADL and IADL Independence in Older Adults

Importance Age-related declines in hearing and vision are common among older adults and are increasingly recognized as key determinants of functional independence. However, limited evidence exists on how sensory function (vision and hearing) shapes longitudinal trajectories of daily functioning over time. Objective To examine longitudinal associations between hearing and vision function and the trajectories of activities of daily living (ADLs) and instrumental activities of daily living (IADLs) among community-dwelling older adults. Design Longitudinal cohort study using latent growth curve modeling. Setting Community-based sample. Participants 2,961 adults aged ≥ 65 years. Outcomes and Measures Self-reported sensory function, and functional performance in ADLs and IADLs. Results The mean age of participants was 73.637 years ( SD = 5.990; 1,207 men, 1,754 women). Both ADL and IADL performance declined over time, with a steeper declines observed for IADLs (slope = −0.517, p < .001) than for ADLs (slope = −0.317, p < .001). Poorer hearing and vision function were associated with lower functional performance across waves, with stronger associations observed for IADL trajectories ( β = 0.063–0.119). All latent growth models demonstrated acceptable fit. Conclusions and Relevance Sensory function was associated with adverse longitudinal functional trajectories, particularly for IADLs. These findings highlight the importance of routine sensory screening in occupational therapy (OT) practice and support older adults across the life span in order to help promote functional independence via stage-specific, individualized OT interventions that target the sensory impairment.