Connections between Vision, Hearing, and Cognitive Function in Old Age.

Abstract

Vision and hearing are basic forms of interchange between the person and the environment, and both senses are subject to pronounced age-related losses that begin quite early in adult life (see Fozard and Gordon-Salant, 2001, for a recent review). Cognitive functioning encompasses a variety of phenomena, including different interpretive and thinking abilities such as inductive reasoning, identification of similarities, and recognition of figural relations; perception; verbal abilities; memory; and everyday problem solving. There can be no doubt that at least a substantial portion of these abilities, particularly those frequently described as the mechanics of intelligence (e.g., perceptual speed), undergo pronounced age-related decrements (P. B. Baltes, 1993; Schaie, 1996). The close association between a person's age and level of function in the domains of vision, hearing, and cognition suggests that there may be significant similarities in the extent to which function in these domains changes as people age. This article summarizes what we currently know about changes in function with age and includes implications for practice. Cognitive functioning, vision, and hearing are all closely related to higher cortical functions. Indeed, one of the big stories of perceptual research in gerontology (Fozard, 1990) has been the idea that sensory functioning must be understood from a central nervous system perspective and not reduced to the peripheral functioning of the end organs. Another important issue is that the everyday competence of older adults, reflected in daily activities such as shopping, taking medication, banking, or using public transportation, has been found to be strongly related to both cognitive capacity and sensory functioning (e.g., Burmedi et al., in press; Marsiske, Klumb, and M. Baltes, 1997). However, there is still not enough evidence to demonstrate any definite causal relation between cognitive functioning, hearing, vision, and day-to-day functioning in later life. That is, while we know that these functions are related, we do not know the exact nature of the relationship. For example, the idea that loss in cognitive functioning in later life is triggered by (earlier) loss in vision and hearing-once thought to be clear-is still very much subject to debate. EMPIRICAL STUDIES Research examining vision, hearing, and cognitive functioning in normally aging adults is far from new. Galton (1883) was among the first to address sensory and cognitive links, and he was also among the first to conduct empirical research with older adults. This search for connections between sensory and cognitive functions, also addressed in earlier gerontological research (e.g., Schaie, P. B. Baltes, and Strother, 1964), found a renaissance during the 1990s in gerontology, particularly because of findings from the Berlin Aging Study on older adults from 70 to 100 years old (Lindenberger and P. B. Baltes, 1994). This, in turn, has stimulated additional research by other excellent research groups in cognitive aging (e.g., Salthouse et al., 1996) and strengthened the insight that only longitudinal designs will bring us nearer to answers about what causes what (Ghisletta and Lindenberger, 2002; Wahl, Tesch-Romer, and Rott, 2000). Cross-sectional findings. Since the beginning of the 1960s, a number of major cross-sectional studies have examined the relationship between vision, hearing, and cognitive functioning across the adult lifespan. Needless to say, it is rather difficult to compare the findings of studies that differ in terms of sample size, setting (private household, laboratory, nursing homes), age range (from early adulthood to very old age), assessment quality (differences in the reliability of instruments both in the cognitive and sensory domain), consideration of sensory modalities (assessment of both vision and hearing versus consideration of only one of these senses), measurement device (a wide range of indicators for vision, hearing, and cognition), and complexity of data analysis. …

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