Study finds hearing impairment associated with lower vision rehabilitation gains

The findings of a new study published in JAMA Ophthalmology¹ suggested that impaired hearing “is independently associated with a lower likelihood of functional gains from vision rehabilitation, underscoring the need for interdisciplinary rehabilitation strategies that are more effective for patients with dual sensory impairment,” according to the investigators led by first author Anas Obaideen, MBBS, MPH. He is from the Wilmer Eye Institute and the Bloomberg School of Public Health, Johns Hopkins University, Baltimore.

Judith E. Goldstein, OD, and Chris Bradley, PhD, from the Wilmer Eye Institute, joined Dr. Obaideen in this study.

Sensory impairment of both vision and hearing loss is a complex barrier to daily functioning. Obaideen and colleagues estimate the global prevalence of dual sensory impairment to be 5.5%, and that is projected to increase by 27.2% by 2050; more than 40% of individuals with vision impairment are thought to also be hearing impaired.^2,3

“Unlike individuals with a single sensory impairment who can often compensate using their remaining senses, those with dual sensory impairment are inhibited in such compensation, leading to greater cognitive load, increased social isolation, and higher rates of cognitive impairment,⁴” they said.

This scenario emphasizes the need to gain an understanding of the role of hearing impairment in vision rehabilitation outcomes, particularly as they relate to functional independence.

Hearing and vision study methodology

In recognition of this unmet need, the investigators conducted a cross-sectional analysis of data from the prospective Low Vision Rehabilitation Outcomes Study.² A total of 28 US centers (611 patients; mean age, 73 years) for outpatient low vision rehabilitation participated from April 2008 to May 2011. All patients were visually impaired and reported their hearing status. Of those, 407 patients had complete follow-up data from after the rehabilitation, Obaideen and colleagues reported.

The study goal was to determine an association between hearing impairment and the likelihood of achieving a clinically meaningful functional improvement following visual rehabilitation. The primary outcome was improved general capability as measured by the Activity Inventory before and after rehabilitation. Rehabilitation was considered effective if the improvement reached a minimum clinically important difference (MCID), they explained.

What did the analysis show?

Among the 611 participants, 253 reported that they were hearing impaired, and the remainder had normal hearing.

The authors reported that the patients’ baseline ability did not differ based on hearing status.

“However, a smaller proportion of participants with hearing impairment achieved an MCID following vision rehabilitation (39/169 [23%] vs. 74/238 [31%]; odds ratio [OR], 0.58; 95% confidence interval [CI], 0.34-0.95; P = 0 .03); this association was not attenuated by possession of hearing aids (17/74 [23%] vs. 21/95 [22%]). In addition to better hearing status, participants with severe vision impairment (OR, 3.32; 95% CI, 1.2-11.86; P = 0 .04) and higher depressive symptoms (OR, 1.38 per logit increase; 95% CI, 1.17-1.63; P < 0 .001) were more likely to achieve an MCID,” Dr. Obaideen and colleagues reported.

The authors concluded, “The low vision patients with hearing impairment were older with lower physical health status scores compared to those with normal hearing, both at baseline and after rehabilitation. Despite similar baseline visual abilities and self-reported vision impairment severity, participants with hearing impairment were less likely to achieve an MCID in Activity Inventory ability following rehabilitation. This difference persisted regardless of history of hearing aid use and was consistent across all levels of self-reported vision status. These results emphasize the importance of addressing hearing-related barriers within vision rehabilitation care and tailoring treatment for individuals with dual sensory impairment.”

References:

1. Obaideen A, Goldstein JE, Bradley C, et al. Hearing impairment and visual rehabilitation outcomes. JAMA Ophthalmol. 2026; published online March 12. doi:10.1001/jamaophthalmol.2026.0207

2. Goldstein JE, Jackson ML, Fox SM,DeremeikJT,MassofRW. Low Vision Research Network Study Group. Clinically meaningful rehabilitation outcomes of low vision patients served by outpatient clinical centers.JAMA Ophthalmol. 2015;133:762-9. doi:10.1001/jamaophthalmol.2015.0693

3. Yeo BSY, Gao EY, Tan BKJ, et al. Dual sensory impairment: Global prevalence, future projections, and its association with cognitive decline.AlzheimersDement. 2025;21:e14465. doi:10.1002/alz.14465

4. Fuller-Thomson E,NowaczynskiA, Macneil A. The association between hearing impairment, vision impairment, dual sensory impairment, and serious cognitive impairment: findings from a population-based study of 5.4 million older adults.J Alzheimers Dis Rep. 2022;6:211-22. doi:10.3233/ADR-220005