The Prevalence of Concurrent Hearing and Vision Impairment in the United States

The Prevalence of Concurrent Hearing and Vision Impairment in the United States T he prevalence of dual sensory impairment (DSI) in hearing and vision has been estimated previously using self-reported data, 1 nonrepresentative population samples, 2 or populations outside of the United States. 3These estimates may not accurately reflect the true burden of DSI in the United States.We determined the prevalence of DSI using objective assessments of hearing and vision in a nationally representative sample of US adults.Methods.We analyzed data from the 1999-2006 cycles of the National Health and Nutritional Examination Surveys (NHANES), a study designed to assess the health of a nationally representative sample of noninstitutionalized, civilian US residents. 4 Air conduction pure-tone audiometry performed in a sound attenuating booth was administered to a halfsample of all participants aged 20 to 69 years from 1999 through 2004 and all participants 70 years or older from 2005 through 2006 according to established NHANES protocols.A speech-frequency pure-tone average (average of hearing thresholds at 0.5, 1, 2, and 4 kHz) greater than 25 dB in the better ear was defined as hearing impairment per World Health Organization criteria. 5 For all participants 20 years or older from 1999 through 2006, visual acuity was determined for each eye using the individual's presenting correction (if any) and reassessed after autorefraction in eyes with a presenting acuity worse than 20/25. 4Visual impairment was defined by having a postautorefraction visual acuity worse than 20/40 in the better-seeing eye.Four categories of sensory impairment were defined: DSI (concurrent hearing and vision impairment); hearing impairment (HI); vision impairment (VI); and no impairment (neither hearing nor vision impairment).Prevalence estimates were determined by age decade and sex.