Abstract
Abstract: :
Purpose: Visual impairment and, to a lesser extent, hearing impairment are independent predictors of reduced survival. This study examines the association between severity of concurrent visual and hearing impairment and mortality, which has not been examined previously. Methods: The National Health Interview Survey (NHIS) is a continuous, multistage, area probability, annual survey of the US civilian non–institutionalized population. Mortality linkage with the National Death Index of 116,796 adult NHIS participants from 1986 to 1994 with complete visual and hearing impairment data was performed through 1997. Household interviews were used to classify participants as: not impaired (n=99,385); one mild/moderate impairment (n=14,923); two mild/moderate impairments (n=1,244); one severe, bilateral impairment (n=1,027); and two severe, bilateral impairments or one severe bilateral impairment plus one mild/moderate impairment (n=217). Results: After adjusting for age, race, marital status, educational level, number of non–ocular/non–auditory conditions, and self–rated health, mortality risk increased as function of the presence and severity of concurrent impairment. In comparison to women with no reported impairment, women in the most severe impairment category were at significantly increased risk of mortality (Hazard Ratio=2.69, 95% confidence interval = [2.03, 3.57]); results for men were also significant but of lower magnitude (1.55, [1.11, 2.15]). Conclusions: Moderate/severe concurrent hearing and visual impairment in women is significantly associated with increased risk of mortality. More modest associations are evident for men and for adults with less severe impairments, irrespective of gender. Prevention of severe visual and hearing impairment should be a national public health priority, especially given the aging of the US population.
Keywords: clinical (human) or epidemiologic studies: risk factor assessment • clinical (human) or epidemiologic studies: outcomes/complications • clinical (human) or epidemiologic studies: prevalence/incidence