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E.–M. Chia, P. Mitchell, C. Huynh, W. Smith, E. Rochtchina, J. Wang, Blue Mountains Eye Study; Impact of Sensory and Other Impairments on Quality of Life and Use of Services in an Older Population: The Blue Mountains Eye Study . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1909.
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Background:The strong age–related increase of impairments in aging populations has generated concern about their cumulative impacts on health–related quality–of–life (HRQOL) and use of health services. Purpose: The impact of four common impairments (vision, hearing, cognitive and mobility) were assessed in the second cross–sectional population–based Blue Mountains Eye Study (n=3509, mean age 66·7 years, 57% women). Methods: HRQOL was measured with the self–administered Short Form 36–item health survey (SF–36) summary physical and mental component scores (PCS and MCS, respectively). Visual impairment was defined as best–corrected visual acuity in the better eye worse than 6/12, hearing impairment as average pure–tone air conduction hearing threshold >25dB over four frequencies in the range 500–4000 Hz in the better ear and cognitive impairment as Mini Mental State Examination (MMSE) score <24/30.Trained examiners determined if participants had mobility impairments (walking difficulties, use of a cane/crutches, walker or wheelchair). Results: Although persons with any of the four impairments had significantly poorer PCS and MCS than corresponding persons without, the presence of two or more impairments was associated with a cumulative linear decline in HRQOL. Successive addition of each impairment was associated with a decrease of 4.0 in the PCS and 2.1 in the MCS, respectively. Age– and sex–adjusted odds significantly and exponentially increased from none to four impairments for the regular use of community support services (1.0, 7.4, 24.9, 47.4 respectively) but these odds were not significant for outpatient attendance or hospital admission within the previous 12 months. Conclusions: The coexistence of two or more common impairments had a linearly cumulative detrimental impact on HRQOL and exponentially increased the likelihood for use of community support services. These data support the need for community support for impaired older individuals to maintain independent living and minimise the growing burden of age–related impairments in ageing populations.
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