Is Sensory Loss an Understudied Risk Factor for Frailty? A Systematic Review and Meta-analysis

Benjamin Kye Jyn Tan, Ryan Eyn Kidd Man, Alfred Tau Liang Gan, Eva K. Fenwick, Varshini Varadaraj, Bonnielin K. Swenor, Preeti Gupta, Tien Yin Wong, Caterina Trevisan, Laura Lorenzo-Lopez, Jose Carlos Millan-Calenti, Carla Helena Augustin Schwanke, Ann Liljas, Soham Al Snih, Yasuharu Tokuda, Ecosse Luc Lamoureux

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Background: Age-related sensory loss and frailty are common conditions among older adults, but epidemiologic research on their possible links has been inconclusive. Clarifying this relationship is important because sensory loss may be a clinically relevant risk factor for frailty. Methods: In this systematic review and meta-analysis, we searched 3 databases for observational studies investigating 4 sensory impairments - vision (VI), hearing (HI), smell (SI), and taste (TI) - and their relationships with frailty. We meta-analyzed the cross-sectional associations of VI/HI each with pre-frailty and frailty, investigated sources of heterogeneity using meta-regression and subgroup analyses, and assessed publication bias using Egger's test. Results: We included 17 cross-sectional and 7 longitudinal studies in our review (N = 34,085) from 766 records. Our cross-sectional meta-analyses found that HI and VI were, respectively, associated with 1.5- to 2-fold greater odds of pre-frailty and 2.5- to 3-fold greater odds of frailty. Our results remained largely unchanged after subgroup analyses and meta-regression, though the association between HI and pre-frailty was no longer significant in 2 subgroups which lacked sufficient studies. We did not detect publication bias. Longitudinal studies largely found positive associations between VI/HI and frailty progression from baseline robustness, though they were inconclusive about frailty progression from baseline pre-frailty. Sparse literature and heterogenous methods precluded meta-analyses and conclusions on the SI/TI-frailty relationships. Conclusions: Our meta-analyses demonstrate significant cross-sectional associations between VI/HI with pre-frailty and frailty. Our review also highlights knowledge gaps on the directionality and modifiability of these relationships and the impact of SI/TI and multiple sensory impairments on frailty.

Original languageEnglish (US)
Pages (from-to)2461-2470
Number of pages10
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Issue number12
StatePublished - Dec 1 2020


  • Gustatory deficit
  • Hearing loss
  • Olfactory dysfunction
  • Sensation disorders
  • Visual impairment

ASJC Scopus subject areas

  • General Medicine


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