Spring 2003
Introduction

Aging and the Senses

By Amy Horowitz and Cynthia Stuen, guest editors

Sensory functions are the critical means by which individuals gain access to information and connect to both their physical environment and the people around them. While normal age-related changes occur in all sensory functions, most are gradual, and older adults can adapt to them without major functional problems. However, impairments in sensory function due to age-related conditions and diseases are prevalent and can have significant consequences for everyday functioning and quality of life among older people. Unfortunately, there are many misconceptions about sensory functioning in later life. Many older people and their families, as well as the professionals who serve them, accept sensory loss as a "normal" part of the aging process. Furthermore, few are fully aware of the range of rehabilitation interventions available for older adults with sensory impairments.

Recently, however, both interest in and information about sensory functioning in later life have increased. Healthy People 2010, the encyclopedic compilation of health-improvement opportunities for the next decade from the U.S. Department of Health and Human Services, has two major goals that reflect the nation's changing demographics. The first goal, which addresses the aging of our population, is to increase the quality and years of healthy life. The second goal, addressing the diversity of our population, is to eliminate the health disparities that exist among different groups. Sensory function is recognized throughout the twenty-nine focus areas of the document, and, for the first time since the Healthy People project began in 1979, a separate chapter is devoted to vision and hearing. It is now extremely timely to look at the current clinical and empirical knowledge base on aging and the senses--and we are very pleased to have been invited by the Generations editorial board to serve as guest editors for this important topic.

One of our major goals as we planned this issue was to clearly differentiate the causes and consequences of normal age-related sensory changes from those of sensory changes or impairments associated with diseases or disorders. To this purpose, the first section of the issue includes four overview chapters on vision, hearing, the chemosensory system, and the somatosensory system. The authors are experts in their respective fields and each addresses, as relevant, normal age-related changes, major age-related disorders, current medical and surgical treatments and interventions, prevalence and risk factor data, and functional consequences. Furthermore, and especially in regard to vision and hearing impairments, each carefully reviews the rehabilitation options that are available. These reviews make clear that we need to expand our conceptualization of rehabilitation from a response to conditions that have acute onset, like hip fractures and strokes, to one that is also applicable to chronic age-related impairments like sensory loss.

With the increasing interest from gerontological and sensory researchers, we are also learning a great deal more about the profound consequences that sensory impairments can have for the everyday lives of older people. In the second section, we focus on three major life domains that can be affected by sensory loss: mental health, especially in terms of increased rates of depression, cognitive functioning, and driving. In addition, the unique circumstances of two special populations are presented--older people with dementia who also experience sensory loss and older people who experience concurrent age-related losses in both vision and hearing. The impact on multiple life domains is particularly severe for these especially vulnerable elders.Technology is changing much about the ways all people function in everyday life, and this is no less true for older adults with sensory impairments. High- and low-tech aids and devices serve as both a complement to, and a component of, vision and hearing rehabilitation services. In the third section, two authors examine both the promises and pitfalls of existing and emerging technology in vision and hearing. The authors also take a look into the not too distant future to see the possibilities for technological solutions for sensory deficits. The chapters on public policy and public health lay out the gaps and issues in current public policies on sensory impairment and underscore the critical need for national policy, given the public-health consequences of sensory impairment in later life.

In the fourth section, we move from the macro policy level to the programmatic level, with articles addressing practical issues relating to environmental design, communications and social support programs. Most important, we hear directly from people who are experiencing sensory losses. The issue concludes with articles by three very special, though not atypical, older adults who reflect on the challenges they have experienced and overcome as they have lived with sensory impairments.

We want to thank all the authors for their contributions to this issue. We anticipate that the material will prove useful both to current professionals in the field working with older adults and to those in academic settings preparing the next generation of practitioners and researchers. When it comes to sensory impairment, here is the basic message we all need to convey to older people and their families, as well as to legislators and policy makers: "No, it is not normal; no, it does not have to be simply accepted; and yes, something can be done."

From Generations Spring 2003 issue, 27(1): 6-7. © 2003 American Society on Aging

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