Third-party impact of dual sensory loss on neuropsychiatric symptom-related distress among friends and family

Background: Vision loss and hearing loss are common in later life and are associated with cognitive impairment and neuropsychiatric symptoms. There is a need to better understand how individual characteristics, such as poor sensory functioning, are linked with familial well-being. Objectives: The aim of this study was to investigate whether, among persons with neuropsychiatric symptoms, age-related sensory loss is related to increased emotional distress reported by their family and friends. Methods: The sample comprised 537 participant-informant dyads from the Personality and Total Health through Life (PATH) study, a community-based cohort. Participants were aged between 72 and 79 years (56% men), and all were reported to exhibit at least 1 neuropsychiatric symptom. Informants were participants' spouse (50%), child (35%), friend (7%), or other relatives (7%). Neuropsychiatric symptom-related distress of friends and family was assessed with the distress subscale of the Neuropsychiatric Inventory (NPI). Sensory functioning in participants was assessed by visual acuity and self-reported hearing difficulties. Ordinal logistic regression analyses estimated the association between sensory problems and NPI distress. Results: In models adjusted for informant dyadic relationship and socio-demographics, both lower visual acuity (B = 0.23, SE = 0.10) and self-reported hearing difficulty (B = 0.15, SE = 0.06) were associated with increased levels of distress. The increased informant distress associated with poor visual acuity was attenuated after adjusting for neurocognitive disorder and health conditions (p = 0.069). A significant interaction between vision and hearing remained after multivariable adjustment (χ2(1) = 6.73, p = 0.010). Conclusions: Friends and family of persons with poor visual acuity and perceived hearing difficulties report elevated levels of neuropsychiatric symptom-related distress relative to friends and family of persons with poor sensory functioning in only 1 sensory domain or unimpaired levels of vision and hearing. These findings provide evidence of the third-party effects of sensory loss in the context of neuropsychiatric symptoms, and in particular show how dual sensory loss can confer additional challenges over and above the effects of a single sensory loss.