Project Summary/Abstract Previous prevalence studies include only small and infrequent estimates of vision, hearing, balance loss or dual sensory loss (DSL) in older adults over aged 80 years, which creates a large gap in knowledge in this important age group. This age group will increase by 600% in the next 30 years, an increase faster than any other age strata, or minority group. Many older patients admitted into institutionalized care have high proportions of untreated VL/HL/DSL. Unfortunately, little data exists on the effectiveness of treating VL/HL/DSL to decrease morbidity, increase quality of life, and decrease caregiver burden and cost in this susceptible age group. This demonstrates a need to understand the prevalence and impact of undiagnosed VL/HL/DSL in community dwelling older adults. Age-related hearing and vision impairment will each rank within the top 10 burdens of disease in middle- and high-income countries in the next 20 years. This evaluation of older persons fits with the National Institutes of Health's new Inclusion Across the Lifespan policy that was implemented in January 2019. The R34 planning grant is to support the development of a detailed infrastructure for a future ?80 Years and Older Vision & Hearing Important Persons Project (80VIP)? under the UG1 Cooperative Agreement funding mechanism. This special population (age >80 years) is rarely included in population-based prevalence surveys or clinical trials, and may require more effort, or new methods to recruit and enroll participants when compared to previous studies. We will also develop a comprehensive manual of procedures, which includes standards for collecting ocular and biometric data, includes new instrumentation, and allows comparisons with previous groundbreaking prevalence surveys. We will also evaluate the burden, feasibility, and suitability of the protocol from the perspective of key stakeholders, which increases the likelihood of a successfully transition into a larger UG1 study; and we will develop a statistical analysis plan that addresses all of the proposed future hypotheses. The study team has the expertise to conduct this proposal, and move this planning grant proposal toward a successful UG1 application. In the future, the experiences and data from this proposal will help plan health resources requirements in the future, and interventions to augment healthy living, prevent morbidity such as institutionalized care, and reduce the high economic costs of vision and hearing loss.