Association between vision and hearing impairments and quality of life: a nationwide survey of Indigenous and non-Indigenous Australians

Vision and hearing impairment, alone or in combination (dual sensory impairment [DSI]), are leading causes of disability worldwide. We aimed to investigate the association of vision impairment, hearing impairment and DSI with health-related quality of life in Indigenous and non-Indigenous Australian adults. A cross-sectional survey using stratified, multi-stage random cluster sampling was conducted between 2022-2025. Participants were systematically assessed for any visual impairment: presenting visual acuity < 6/12 (better eye). Any hearing impairment and moderate or worse hearing impairment were defined as pure tone average (PTA) > 25 decibels hearing level (dB HL), and > 40dBHL, respectively. DSI cases included persons with any vision impairment and either, any or moderate to worse hearing impairment. Health-related quality of life was assessed using the EuroQoL EQ-5D-5 L scale comprising Index and Visual Analogue Summary (VAS) scores. 1,995 participants (mean age 70.7 years) had complete data. Among Indigenous participants ( n = 150), no statistically significant associations were observed in EQ-5D-5 L scores between those with and without sensory impairment. Non-Indigenous participants ( n = 1,845) with vision impairment versus those without vision impairment had lower mean Index scores (poorer quality of life): 0.77 (95% confidence intervals, CI, 0.73–0.81) and 0.80 (95% CI 0.78–0.82), respectively, p = 0.044. Compared to non-Indigenous participants without hearing problems, those with mild or moderate hearing impairment had lower mean VAS scores (poorer quality of life): 67.56 (95% CI 65.21–69.91; p = 0.009) and 66.64 (95% CI 64.11–69.17; p = 0.005), respectively. Non-Indigenous adults with any DSI versus those without had lower mean Index scores: (0.80 versus 0.75; p = 0.005); and VAS scores (68.51 versus 64.24; p = 0.028). Sensory impairment was linked to reductions in quality of life among non-Indigenous Australians, particularly for hearing loss and DSI. In contrast, no statistically significant EQ-5D-5 L differences by sensory status among Indigenous participants were observed, underscoring a critical evidence-gap that cannot be resolved without larger Indigenous samples and culturally attuned measures that better capture determinants of wellbeing. These findings support integrated vision–hearing detection and care as a pragmatic strategy to optimising quality of life, while reinforcing the need to strengthen Indigenous-led research to ensure outcomes that matter is being measured and acted on. Not applicable.