Evaluating Whether Sight Is the Most Valued Sense (2024)

Associated Data

Supplementary Materials

Key Points

Abstract

This cross-sectional study evaluates the ranking of sight among 8 senses among UK adults.

Introduction

Research in the United States has shown that members of the public rate sight loss as a greater concern than loss of memory, loss of speech/hearing, or chronic health conditions, such as HIV/AIDS and heart disease.¹ Similarly, a longitudinal clinical study with patients experiencing sensory loss has shown that loss of sight and touch cause the greatest decreases in quality of life before loss of hearing, taste, and smell.² However, to our knowledge, the relative importance of sight compared with other senses has not been systematically investigated in the general population in a nonclinical setting. We therefore conducted a survey to determine which senses are rated most valuable by a cross-section of the public and quantified attitudes toward sight and hearing loss in particular using a time tradeoff (TTO) exercise.

Methods

This study was approved by the City, University of London School of Health Science’s research ethics committee. Written informed consent was obtained from all participants before enrollment. An online survey was delivered by an independent market research company, FlexMR (FlexMR Ltd), who was contracted by the research team specifically to disseminate the survey and collate responses. FlexMR sampled 250 UK-based adults in March 2016 (median [range] age: 50 years [22-80 years]; 141 women [56.4%]). The participants were selected from a pool of UK-based individuals who had previously registered to receive survey invitations from FlexMR and were entered into a prize draw as compensation. Participants’ sociodemographic characteristics were collected (eTable in the Supplement). The survey was open to individuals who may have had a sensory impairment themselves or within their family.

This study adopted a broader definition of senses than the 5 “traditional” senses defined by Aristotle, also including balance (equilibrioception), pain (nociception), and temperature (thermoception). Participants were first asked to rank 8 senses (sight, hearing, touch, smell, taste, balance, temperature, and pain) in order of most valuable (8) to least valuable (1). Next, the fear of losing sight and hearing was investigated using a TTO exercise.³ Participants chose between 10 years without sight/hearing (life A) vs varying amounts of perfect health in 1-year decrements from 10 to 0 years (life B). This allowed for the calculation of the number of years without sight or hearing that a participant would trade for perfect health over a 10-year period. Differences in years traded between groups were then analyzed using Wilcoxon rank sum and Kruskal-Wallis tests. Statistical analyses were performed using R, version 3.5 (R Foundation), and statistical significance was set at α = .05.

Results

As shown in Figure 1, 220 participants (88%; 95% CI, 82%-94%) ranked sight as their most valuable sense (mean [SD] rank, 7.8 [0.9]; 95% CI, 7.6-7.9). Hearing was ranked as the second-most valuable sense (mean [SD] rank, 6.2 [1.3]; 95% CI, 6.1-6.4) but was rated as significantly less valuable than vision (P < .001). Balance was ranked as the third-most valuable sense (mean [SD] rank, 4.9 [1.7]; 95% CI, 4.7-5.1), above the 3 traditional senses of touch (mean [SD] rating, 4.5 [1.7]), taste (mean [SD] rating, 3.8 [1.8]), and smell (mean [SD] rating, 3.4 [1.7]) (Wilcoxon signed rank test for pairwise comparison between balance and touch, W = 36 333; P = .04 after Bonferroni correction).

In the TTO exercise, participants, on average, chose 4.6 years (95% CI, 4.2-5.0) of life in perfect health over 10 years of life with complete sight loss and 6.8 years (95% CI, 6.5-7.2) of life in perfect health as an alternative to 10 years of life with complete hearing loss. This means that over a 10-year period, participants were prepared to sacrifice a mean (SD) 5.4 (3.1) years without sight (95% CI, 5.0-5.8) and 3.2 (2.9) years without hearing (95% CI, 2.8–3.5) to remain in perfect health (mean difference between sight and hearing, 2.2 years; P < .001). Thirty-eight participants (15%) chose death (0 years of life B) over 10 years with complete sight loss and 15 participants (6%) chose death over 10 years with complete hearing loss (Figure 2).

Men were willing to sacrifice almost 1 year more without sight than women in exchange for perfect health (mean difference, 0.94 years; P = .03) (Figure 2). There were no statistically significant differences in the number of years without sight that participants would give up based on age group (mean [SD] for age 22-40 years, 5.3 [3.1]; mean [SD] for age 41-60 years, 5.3 [3.3]; mean [SD] for age 61-80 years, 5.6 [3.0]; Kruskal-Wallis test, H₂ = 0.99; P = .61), family history of sensory impairment (mean [SD] for those with a family history, 4.8 [3.3]; mean [SD] for those without a family history, 5.5 [3.1]; Wilcoxon rank sum test, W = 4491; P = .17), or having a chronic health condition (mean [SD] for those with a chronic health condition, 5.2 [3.2]; mean [SD] for those without a chronic condition, 5.5 [3.1]; Wilcoxon rank sum test, W = 7583.5; P = .48). For hearing, people with a family history of sensory impairment would give up significantly fewer years without hearing than those with no family history of sensory impairment (mean difference, −1.46 years; P < .01). Participants with chronic conditions would give up fewer years without hearing than those with no chronic conditions (mean difference, −0.56 years; P = .04). There were no statistically significant differences in the number of years without hearing that participants would give up based on age (mean [SD] for age 22-40 years, 3.3 [3.0]; mean [SD] for age 41-60 years, 2.9 [2.9]; mean [SD] for age 61-80 years, 3.3 [2.8]; Kruskal-Wallis test, H₂ = 1.54; P = .46) or sex (mean [SD] for women, 3.1 [2.9]; mean [SD] for men, 3.3 [2.9]; Wilcoxon rank sum test, W = 7247; P = .44).

Discussion

The results suggest that sight is the most valued sense, followed by hearing. This is consistent with convergent evidence from linguistics, showing that words associated with vision dominate the English lexicon.⁴ Balance was also ranked highly as the third most important sense ahead of touch, taste, and smell. This is consistent with empirical evidence showing that balance impairments and their association with mobility and daily activities can be a key factor in reduced quality of life.⁵ This further shows that the 5 traditional Aristotelian senses do not comprise the most valued senses.

The TTO exercise showed that people would choose an average of 4.6 years of perfect health over 10 years without sight and 6.8 years of perfect health over 10 years without hearing. Men opted to sacrifice almost 1 year more without sight than women. Interestingly, men’s higher valuation of sight in this study does not reflect real-world health care–seeking behavior, with evidence that men are more likely than women to risk neglecting their eye health. For example, individuals presenting with late-stage glaucoma are 16% more likely to be male.⁶

Regarding hearing loss, those with chronic conditions would give up fewer years without hearing than those with no chronic condition. This aligns with theories on “focusing effects” whereby healthy individuals, when asked to focus on the perceived effect of a disease or disability, frequently overestimate its negative association with their quality of life and disregard the many other contextual factors which could mitigate its effect, such as the possibilities of adaptation.⁷ However, a similar pattern was not found for sight loss; those with chronic conditions sacrificed only marginally fewer years without sight, demonstrating that sight is valued similarly highly by those with and without existing chronic health conditions.

Conclusions

This study, conducted among a cross-section of the UK public, supports the notion that sight is the most highly valued sense, followed by hearing and balance. The study suggests that people would on average choose 4.6 years of perfect health as an alternative to 10 years without sight. Future research could explore how such results generalize to other parts of the world and public perceptions regarding multisensory loss.

Notes

References