Dual-Sensory Loss Impacts Older Adults’ Health

Olfactory and hearing impairment together is the most common form of dual sensory loss in older adults in Singapore, affecting over one in five people aged 60 and above. This combination, more than vision and hearing loss, is linked to a higher risk of losing independence and shows a trend toward increased healthcare costs. These findings come from a large, population-based study of 2,048 older Asian adults published in *Scientific Reports*.

How Researchers Measured Sensory Loss in an Aging Population

Led by researchers Isabelle Nooteboom, Eva Fenwick, and Ryan E.K. Man, the study assessed a multi-ethnic population of Singaporeans aged 60 and older. The team used validated clinical tests, moving beyond self-reporting for accurate data. Vision impairment was measured using visual acuity tests. Hearing impairment was assessed with pure-tone audiometry. Olfactory (smell) impairment was tested using a “Sniffin’ Sticks” odor identification test. This rigorous methodology allowed the researchers to define three types of dual sensory impairment (DSI): vision and hearing (VI+HI), vision and smell (VI+OI), and hearing and smell (OI+HI). They then analyzed this data against demographics, health status, functional independence, and healthcare costs.

Olfactory and Hearing Loss Emerges as the Most Prevalent Pairing

The prevalence figures were striking. After adjusting for age, sex, and ethnicity, the rate of combined vision and smell loss was 1.0%. Combined vision and hearing loss—often the focus of aging research—had a prevalence of 7.3%. The most common combination by far was olfactory and hearing impairment, affecting 21.7% of participants.

“This high prevalence of OI+HI is a notable finding,” the authors state, highlighting a sensory loss pairing that receives less clinical attention. The study also identified distinct risk profiles. Older age and having multiple chronic conditions (multimorbidity) were linked to VI+HI. For OI+HI, the significant factors were older age, being male, living alone, and being a current smoker.

Dual Sensory Loss Linked to Lower Quality of Life and Independence

The impact on daily life was significant. Participants with combined vision and hearing loss reported statistically lower health-related quality of life scores. Both the VI+HI and OI+HI groups were more than twice as likely to have impaired Instrumental Activities of Daily Living status. IADLs include complex tasks like managing medications, finances, and transportation—skills essential for independent living.

“The association of DSI with lower IADL status suggests that these combined deficits have a tangible, negative effect on functional independence,” the researchers explain. Furthermore, the OI+HI group showed a non-significant trend toward higher annual healthcare costs compared to those without dual impairment, pointing to a potential economic burden.

Practical Implications for Screening and Patient Care

This study provides a clear call to action for clinicians and public health strategies. The high prevalence of olfactory and hearing loss, and its link to functional decline, suggests that screening for one sense should prompt evaluation of the other, especially in older males and those living alone. Proactive identification can lead to timely interventions, such as hearing aids, audiological rehabilitation, and safety counseling, which may help preserve independence.

For individuals with combined vision and hearing loss, the direct impact on quality of life underscores the need for integrated care models that address the compounded communicative and social challenges. A New Tinnitus Care Model: Integrating Sensation and Emotion discusses a similar holistic approach, which could be relevant for managing the complex needs of those with dual sensory loss.

The findings also have relevance for conditions like tinnitus and hyperacusis, often linked to hearing loss. A comprehensive Auditory System Evaluation in Tinnitus Patients is critical, and this study suggests adding a simple smell screening for older patients could provide a more complete picture of sensory health. Furthermore, as research into interventions like Transcranial Stimulation for Tinnitus and Hearing Disorders advances, understanding these comorbid sensory impairments will be important for defining patient subgroups and treatment outcomes.

Conclusion: A Focus on Combined Sensory Health in Aging

The research by Nooteboom and colleagues shifts the focus to the under-recognized burden of combined hearing and smell loss in the elderly. With a global aging population, early identification of these dual impairments is a practical step. Targeted screening of high-risk groups can facilitate interventions that aim to mitigate functional decline, improve quality of life, and potentially manage rising healthcare costs associated with sensory loss.

Source: Nooteboom, I., Fenwick, E. & Man, R.E.K. Prevalence, risk factors, impact and health-related costs of dual sensory impairment in a multi-ethnic older Asian population. Sci Rep (2024). https://doi.org/10.1038/s41598-026-40484-9

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