title: Vision impairment and dual sensory problems in middle age.
abstract: OBJECTIVE
  Vision and hearing impairments are known to increase in middle age. In this study we describe the prevalence of vision impairment and dual sensory impairment in UK adults aged 40-69 years in a very large and recently ascertained data set. The associations between vision impairment, age, sex, socioeconomic status, and ethnicity are reported.
  
  
  METHODS
  This research was conducted using the UK Biobank Resource, with subsets of UK Biobank data analysed with respect to self-report of eye problems and glasses use. Better-eye visual acuity with habitually worn refractive correction was assessed with a logMAR chart (n = 116,682). Better-ear speech reception threshold was measured with an adaptive speech in noise test, the Digit Triplet Test (n = 164,770). Prevalence estimates were weighted with respect to UK 2001 Census data.
  
  
  RESULTS
  Prevalence of mild visual impairment (VA >0.1 logMAR (6/7.5, 20/25) and ≥0.48 (6/18, 20/60)) and low vision (VA >0.48 (6/18, 20/60) and ≥1.3 (6/120, 20/400)) was estimated at 13.1% (95% CI 12.9-13.4) and 0.8% (95% CI 0.7-0.9), respectively. Use of glasses was 88.0% (95% CI 87.9-88.1). The prevalence of dual sensory impairment was 3.1% (95% CI 3.0-3.2) and there was a nine-fold increase in the prevalence of dual sensory problems between the youngest and oldest age groups. Older adults, those from low socioeconomic and ethnic minority backgrounds were most at risk for vision problems.
  
  
  CONCLUSIONS
  Mild vision impairment is common in middle aged UK adults, despite widespread use of spectacles. Increased likelihood of vision impairment with older age and with ethnic minorities is of concern given ageing and more ethnically diverse populations. Possible barriers to optometric care for those from low socioeconomic and ethnic minority backgrounds may require attention. A higher than expected prevalence of dual impairment suggests that hearing and vision problems share common causes. Optometrists should consider screening for hearing problems, particularly among older adults.
authors.affiliation: School of Psychological Sciences, University of Manchester, Manchester, UK.
authors.forename: Piers
authors.initials: P
authors.lastname: Dawes
authors.forename: Christine
authors.initials: C
authors.lastname: Dickinson
authors.forename: Richard
authors.initials: R
authors.lastname: Emsley
authors.forename: Paul N
authors.initials: PN
authors.lastname: Bishop
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Cruickshanks
authors.forename: Mark
authors.initials: M
authors.lastname: Edmondson-Jones
authors.forename: Abby
authors.initials: A
authors.lastname: McCormack
authors.forename: Heather
authors.initials: H
authors.lastname: Fortnum
authors.forename: David R
authors.initials: DR
authors.lastname: Moore
authors.forename: Paul
authors.initials: P
authors.lastname: Norman
authors.forename: Kevin
authors.initials: K
authors.lastname: Munro
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D005260:Female; D006311:Hearing Disorders / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012737:Sex Factors; D012959:Socioeconomic Factors; D006113:United Kingdom / Q000453:epidemiology; D014786:Vision Disorders / Q000453:epidemiology*; D014792:Visual Acuity
keywords: Biobank; barriers to care; dual sensory problems; middle age; vision impairment