Background Sensory impairment is common in old age and associated with morbidity. However few studies have investigated the impact of sensory impairment on long-term cause-specific mortality risks in older adults. We explored the association between impairments in hearing and vision and the risk of mortality from coronary heart disease (CHD), cardiovascular disease (CVD) and all-causes over 10 years.
Methods A socioeconomically representative cohort of 3981 men from 24 British towns was followed up from 2003 to 2013. Hearing impairment was defined by self-reported data on hearing aid use and ability to follow television at a volume acceptable to others and categorised into: could hear (no hearing impairment), could hear with aid, could not hear and no aid, and could not hear despite aid. Vision impairment was defined as not being able to recognise a friend across a road. Dual sensory impairment was defined as reporting poor vision and any of the three groups of hearing impairment. The Cox proportional hazards model was used to calculate hazard ratios (HR) with 95% confidence intervals (95% CIs) for mortality.
Results During follow-up, 1463 deaths including 308 CHD deaths and 408 CVD deaths occurred. Men who reported not being able to hear and not using a hearing aid had increased risks of all-cause mortality (HR 1.19, 95% CI 1.01, 1.40) and CVD mortality (age-adjusted HR 1.37, 95% CI 1.02, 1.85). Vision impairment (HR 1.67, 95% CI 1.31, 2.13) and dual sensory impairment (HR 1.89, 95% CI 1.35, 2.65) were also associated with all-cause mortality, but not with CVD mortality. Only the association of vision impairment with all-cause mortality remained significant after adjustment for social class, obesity, smoking, physical inactivity, diabetes and prevalent CVD. Sensory impairments were not associated with CHD mortality.
Conclusion Older men with hearing impairment, vision impairment and dual sensory impairment have an increased risk of all-cause mortality over 10 years. Hearing impaired older men also have an increased risk of CVD mortality. Our findings suggest that the associations between hearing impairment and mortality are explained by social class and behavioural factors, while vision impairment appears to be independently associated with all-cause mortality. Further research is warranted on the possible mechanisms of mortality in visually impaired older adults.
- sensory impairments
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