A R DiNuzzo, K S Markides
University of Texas Medical Branch, Preventive Medicine and Community Health, Galveston, United States
Background: This study examines the direct longitudinal impact of visual and hearing impairment on functional status and the interactive effects of consequences associated with overall sensory impairment as predictors of disability and mortality.
Methods: Data were collected for the Hispanic Established Populations for the Epidemiological Study of the Elderly (HEPESE), a seven-year prospective-cohort study examining 3,050 non-institutionalized Mexican Americans aged 65 or older. Visual acuity was assessed using a modified Snellen test. Hearing impairment was based on lifetime use of hearing aides or self-reported hearing loss using the 10-item Hearing Handicap Inventory for the Elderly-Screening version (HHIE-S).
Results: Subjects with visual or hearing impairment were strongly associated with age; females were more likely to be visually impaired whereas males reported more hearing impairment. Subjects with only moderate visual impairment as well as those with any degree of hearing impairment were more likely to have depressive symptoms. Extent of emotional isolation and self-esteem was not associated with visual or hearing impairment. Sensory impairment was predictive of functional limitation (OR=1.43, 95% CI=1.18-1.7), disability (OR=1.63, 95% CI=1.2-2.2) and increased risk of mortality (hazard ratio=1.9, 95% CI=1.5-2.4) after controlling for sociodemographic and heath-related variables. While still predictive of disability and mortality, sensory impairment combined with depressive symptamatology only increased the risk of functional limitation (OR=2.54, 95% CI=1.8-3.6).
Conclusion: Although sensory impairment is an important predictor of disability and mortality among older Mexican Americans, the interactive effects of depression and sensory impairment may have important implications on adaptation, resource utilization, and long-term health outcomes.
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