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Health-related quality of life associated with sensory impairment in Chinese middle-aged and older adults: a cohort study
  1. Yue Ding1,
  2. Yuhan Yan2,
  3. Yong Tian1,
  4. Wei Du1,
  5. Lijun Fan1
  1. 1 Department of Public Health, Southeast University, Nanjing, Jiangsu, China
  2. 2 Department of Geriatrics, General Hospital of Eastern Theater Command, Nanjing, Jiangsu, China
  1. Correspondence to Lijun Fan, Southeast University, Nanjing, Jiangsu, China; fanlijun{at}


Background The impact of sensory impairment (SI) on individual multidimensional health has not been adequately explored in developing countries. This study examined the association of hearing or/and visual impairment with health-related quality of life (HRQoL) in the Chinese middle-aged and older population, and further explored potential discrepancies in associations by gender and rural–urban residence.

Methods This cohort study used four-wave data during 2011–2018 from the China Health and Retirement Longitudinal Study, and enrolled 13 342 community-dwelling adults aged 45 years or older. We employed linear mixed effects models to estimate the longitudinal associations between SI and HRQoL, and conducted interaction tests to assess gender or rural–urban differences in above associations.

Results Hearing impairment (HI) and visual impairment (VI) were separately and jointly associated with deteriorated overall HRQoL and decreased physical/mental component of HRQoL (all β<0, all p<0.05), and in particular, dual sensory impairment (DSI) exhibited greater impacts on HRQoL than either HI or VI alone. The impacts of SI on HRQoL were more evident among women or rural population than their counterparts (all p for interaction<0.05).

Conclusion This study observed decreased HRQoL in association with SI. The greater impact of DSI underlines the need for integrated care for comorbid sensory conditions. Our findings also indicate the necessity to reduce the burden of SI among more vulnerable populations such as females and rural adults.


Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • Contributors Study concept and design: YD, YT, WD and LF. Acquisition of data: YD, YY and LF. Analysis and interpretation of data: YD, YY, WD and LF. Drafting the manuscript: YD and LF. Critical revision of the manuscript for important intellectual content: all authors. LF acts as guarantor.

  • Funding This work was supported by the Natural Science Foundation of China (NSFC 71704192); the Department of Education of China (No. 1125000172); the Fundamental Research Funds for the Central Universities (2242021R41104, 2 242 021S40011, 3225002002A1); and the Zhishan Youth Scholar Programme of Southeast University (2019–2021). The sponsors had no role in the design, methods, subject recruitment, data collections, analysis and preparation of the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.