Longitudinal changes in sensory impairments and subsequent falls and fall-related injuries among middle-aged and older adults: a pooled analysis of four prospective cohorts

Abstract Background Visual and hearing impairments are recognized as modifiable risk factors for falls. However, evidence on the longitudinal effects of changes in sensory status on the risk of falls and fall-related injuries remains limited. This study aimed to examine the association between changes in sensory impairment status and the incidence of falls and fall-related injuries among middle-aged and older adults. Methods Self-reported visual and hearing impairments were assessed at baseline and at a follow-up survey conducted two to three years later. The primary outcomes were incident falls and fall-related injuries. Modified Poisson regression models with robust standard errors were used to estimate risk ratios (RRs) and 95% confidence intervals (CIs). Results A total of 22,287 participants were included in the main analysis. Compared with maintaining good sensory function, new-onset sensory impairments, recovery from sensory impairments, and persistent sensory impairments were associated with higher risks of falls and fall-related injuries. New-onset sensory impairments were associated with a 20% higher risk of falls (RR = 1.20, 95% CI: 1.13–1.26) and a 37% higher risk of fall-related injuries (RR = 1.37, 95% CI: 1.22–1.54). Recovery from sensory impairments was associated with a modestly increased risk of falls (RR = 1.08, 95% CI: 1.02–1.15) and fall-related injuries (RR = 1.21, 95% CI: 1.07–1.38), while persistent sensory impairments were associated with the highest risks (falls: RR = 1.24, 95% CI: 1.18–1.29; fall-related injuries: RR = 1.45, 95% CI: 1.32–1.60). When compared with persistent sensory impairments, recovery was associated with a significantly lower risk of falls (RR = 0.88, 95% CI: 0.83–0.93) and fall-related injuries (RR = 0.83, 95% CI: 0.74–0.94). Conclusions Longitudinal changes in sensory impairments are strongly associated with the risk of falls and fall-related injuries. Recovery from sensory impairment appears to be linked to a reduced risk, underscoring the potential benefits of interventions aimed at restoring sensory function.