Sensory impairment is prevalent among older adults and a recognized risk factor for falls and fractures. However, prior studies treated sensory impairment as a static, point-in-time exposure, overlooking its progressive nature. This study investigated the association between the long-term, cumulative burden of sensory impairment and risks of falls and hip fractures in older adults.

This longitudinal investigation included 3391 participants aged ≥60 years from the China Health and Retirement Longitudinal Study (CHARLS). Average cumulative sensory impairment scores (dual, visual, and auditory) were calculated across four waves (2011–2018) using the area under the curve. Incident falls and hip fractures were assessed through self-report during follow-up (2013–2020). Cox proportional hazards models and restricted cubic spline analyses evaluated associations.

During follow-up, 1576 falls and 189 hip fractures occurred. In fully adjusted models, compared with the lowest quartile (Q1), participants in the highest quartile (Q4) of average cumulative dual sensory impairment exhibited a 36% higher fall risk (HR = 1.36, 95% CI: 1.18–1.58) and a 116% higher hip fracture risk (HR = 2.16, 95% CI: 1.36–3.45). Significant linear trends were evident for both outcomes (P for trend <0.01). Similar graded associations were found for visual and auditory impairment separately. Restricted cubic spline analyses confirmed monotonic, linear dose-response relationships.

The long-term burden of sensory impairment is independently and dose-dependently associated with increased risks of falls and hip fractures. These findings highlight the importance of dynamic sensory monitoring and integrating sensory health management into prevention strategies.

not applicable.