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Ronald Klein, MD; Karen J. Cruickshanks, PhD; Barbara E. K. Klein, MD; David M. Nondahl; Terry Wiley, PhD

Arch Ophthalmol. 1998;116:360-365.

Objective  To describe the relationship of age-related maculopathy (ARM) to hearing loss.

Design  Population-based cohort study.

Participants  All 3397 adults (age range, 48-92 years) living in Beaver Dam, Wis, who were examined for age-related eye disease and hearing loss from March 1, 1993, to July 18, 1995, and who had analyzable hearing thresholds in at least 1 ear and fundus photographs gradable for ARM in at least 1 eye.

Methods  Characteristics of drusen and other lesions typical of ARM were determined by grading stereoscopic color fundus photographs using the Wisconsin Age-Related Maculopathy Grading System. We used standard protocols of pure-tone air-conduction audiometry to assess hearing loss, which was defined as the pure-tone average of hearing thresholds at 500, 1000, 2000, and 4000 Hz greater than 25-dB hearing level.

Results  The prevalence of ARM was 25.4% and of hearing loss was 45.0% in this population. Both conditions were present in 15.1%. The relationships between early ARM lesions and hearing loss were not statistically significant. After controlling for age and sex, persons with late ARM were more likely (odds ratio, 3.15; 95% confidence interval, 1.34-7.42) to have hearing loss than persons without late ARM. This relation did not change when other factors related to ARM or hearing loss (eg, cigarette smoking status, history of occupational noise exposure, and history of cardiovascular disease) were entered into multivariate models.

Conclusions  These population-based estimates document the frequent coexistence of signs of ARM and hearing loss. As late ARM is an important cause of loss of vision, and as hearing loss is associated with difficulty in communicating, the high frequencies of sensory comorbidity may affect maintenance of independent functioning as people age. Further study is necessary to examine why late ARM and hearing loss are associated.

From the Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School (Drs R. Klein, Cruickshanks, and B. Klein and Mr Nondahl), and the Department of Communicative Disorders, University of Wisconsin (Dr Wiley), Madison.

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