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D.J. Lee, O. Gómez–Marín, B.L. Lam, D.D. Zheng, A.J. Caban; CONCURRENT VISUAL AND HEARING IMPAIRMENT AND RISK OF MORTALITY: THE NATIONAL HEALTH INTERVIEW SURVEY . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1379.
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Background: Visual impairment (VI) and hearing impairment (HI) are independently associated with reduced survival in adults but whether concurrent VI and HI further increases mortality risk has not been conclusively established. Objective: To estimate the effect of concurrent VI + HI on all–cause mortality. Methods: The National Health Interview Survey (NHIS) is an annual representative cross–sectional survey of the US civilian non–institutionalized population. Selected families are interviewed using a primary household respondent with all adults within the home participating in the interview. A randomly selected sub–group of NHIS participants was administered a chronic conditions list that included questions about VI and HI. Mortality linkage with over 96% of participants from the 1986–1994 NHIS was performed by the National Center for Health Statistics through 1997. Complete data were available on 116,796 adults 18 years of age and older. Statistical methods included Cox regression models with adjustment for survey design, age, gender and self–rated health. Results: The prevalence rates of reported VI only and HI only were 4.3% and 11.8%, respectively; the prevalence of both VI + HI was 1.25%. Mortality linkage identified 8,949 deaths; the average follow–up was 7.0 years. In multivariate analyses, participants reporting VI or HI only were at significantly increased risk of death relative to participants not reporting either impairment (Hazard Ratios, HR= 1.29, 95% CI: [1.17–1.42]; 1.10, [1.04–1.16], respectively); the relative risk of death was highest among participants reporting both VI + HI (1.56, [1.39–1.75]). Models incorporating impairment severity indicated that those reporting concurrent moderate to severe HI + VI were at greatest risk of death (2.01, [1.58–2.56]). Conclusion:The simultaneous occurrence of VI and HI increases the risk of death more than either impairment alone; adults with more severe concurrent impairment are at greatest risk of death.
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