The prognostic value of sensory impairment in older persons

OBJECTIVES: To determine the relationships between visual and hearing impairment and subsequent functional dependence and mortality among community-dwelling older persons. DESIGN: A Prospective, cohort study. SETTING: Community-based. PARTICIPANTS: A total of 5444 men and women aged 55 to 74 years at baseline. MEASUREMENTS: Self-reported and measured visual impairment, self-reported and measured hearing impairment, self-reported and measured combined sensory impairment, 10-year mortality, and dependency in activities of daily living (ADL), instrumental ADL (IADL), and Rosow-Breslau (RB) function. RESULTS: In multiply-adjusted models, adjusting for length of follow-up, socio-demographic characteristics, and chronic conditions, only measured visual impairment was predictive of mortality. Measured visual impairment was also predictive of 10-year ADL and IADL dependence; measured hearing impairment was predictive of RE dependence. Self-reported visual impairment predicted functional impairment on all scales at 10 years, although self-reported hearing impairment predicted only subsequent RE dependence. Measured combined impairment was associated with the highest risk of 10-year functional dependence. CONCLUSIONS: Sensory impairment is predictive of subsequent functional impairment in older persons.