Sensory impairments and caregiver burden: a population-based study of older adults in Thailand

Abstract Background Visual and hearing impairments can increase dependence across the life course; however, their impact may be particularly pronounced in older adults due to age-related functional decline and increased care needs. This study examined how caregiver burden differs by type of sensory impairment, including vision impairment, hearing impairment, and dual sensory impairment. Methods A cross-sectional secondary data analysis was performed. Data were obtained from the 2021 Survey of Older Persons in Thailand, conducted by the National Statistical Office. The study sample comprised 3,190 pairs of older adults aged 60 and above and their primary caregivers. Visual and hearing impairments were defined based on self-reported functional difficulty with or without assistive devices. Caregiver burden was assessed using a self-reported single-item question on a 0–10 scale, with a higher score indicating greater burden, and was recoded into three categories: no burden (score 0), low burden (scores 1–3), and high burden (scores ≥ 4), based on the median score. Generalized ordinal logistic regression, adjusted for caregiver background, older adults’ health status, physical environment, and socioeconomic factors within the older adults’ household, was used to examine the relationship between caregiver burden and sensory impairments. Results Among older adults, 13.3%, 11.9%, and 27.0% had visual impairment, hearing impairment, and dual sensory impairment, respectively. Median burden score was 3 (IQR: 0–5), indicating low burden overall. Compared to caregivers of older adults without sensory impairments, those caring for individuals with hearing impairment were more likely to report higher levels of burden (AOR 1.55, 95% CI 1.24–1.94). Elevated odds of burden were also observed for caregivers of older adults with dual sensory impairments (AOR 1.29, 95% CI 1.08–1.54) and vision-only impairment (AOR 1.26, 95% CI 1.02–1.56). Conclusions Hearing impairment was associated with elevated caregiver burden, with the association being stronger than that observed for dual sensory impairments. This counterintuitive finding may reflect communication barriers, social isolation, and the less obvious nature of hearing loss, but it should be viewed with caution because of unmeasured factors like impairment severity and support availability.