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The Relationship of Vision and Hearing Impairment to One-Year Mortality and Functional Decline

Brown University

William D. Spector, PhD

Agency for Health Care Policy and Research

Josef Sternberg, MD

Veteran Administration Medical Center, Providence, RI

Impairments in hearing and vision are common for those aged 65 and older, and severe impairments may result in dependencies in daily activities. This article presents a longitudinal analysis of the risk of dying, or experiencing increased dependency in activities of daily living (ADLs) or instrumental activities of daily living (IADLs) for persons with self-rated hearing and/or visual impairment. The data are from baseline and 1-year follow-up of the GAO-Cleveland study of 1,408 community-dwelling elders. Bivariate and multiple logistic regression analyses were performed. Vision impairments and, to a lesser extent, hearing impairments were found to be significant risk factors for functional decline. After adjustment for age, sex, and cognitive status, persons who were otherwise free of functional dependency at baseline but who had only vision impairment or both vision and hearing impairments were 2.5 and 3.5 times more likely to experience functional decline than were unimpaired elderly persons, respectively. Those similarly impaired, but with IADL disability, were 1.8 and 2.5 times more likely to experience functional decline than were unimpaired elderly. Policy implications of these findings are discussed.

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