Comparative impact of hearing and vision impairment on subsequent functioning.
OBJECTIVE
The purpose of this study was to compare independent impacts of two levels of self-reported hearing and vision impairment on subsequent disability, physical functioning, mental health, and social functioning.


METHODS
A 1-year prospective cohort study.


METHODS
San Francisco Bay Area, California.


METHODS
Two thousand four hundred forty-two community-dwelling men and women age 50 to 102 from the Alameda County Study (California).


METHODS
Hearing and vision impairment were assessed in 1994. Outcomes, measured in 1995, included physical disability (activities of daily living, instrumental activities of daily living, physical performance, mobility, and lack of participation in activities), mental health (self-assessed, major depressive episode), and social functioning (feeling left out, feeling lonely, hard to feel close to others, inability to pay attention). All 1995 outcomes were adjusted for baseline 1994 values.


RESULTS
Both impairments had strong independent impacts on subsequent functioning. Vision impairment exerted a more wide-ranging impact on functional status, ranging from physical disability to social functioning. However, the results also highlighted the importance of hearing impairment, even when mild.


CONCLUSIONS
These impairments can be partially ameliorated through prevention, assessment, and treatment strategies. Greater attention to sensory impairments by clinicians, patients, public health advocates, and researchers is needed to enhance functioning in older adults.
Wallhagen
M I
MI
Department of Physiological Nursing, School of Nursing, University of California, San Francisco, California 94143, USA.
Strawbridge
W J
WJ
Shema
S J
SJ
Kurata
J
J
Kaplan
G A
GA
D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006311:Hearing Disorders / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012495:San Francisco / Q000453:epidemiology; D012720:Severity of Illness Index; D012737:Sex Factors; D012917:Social Adjustment; D014786:Vision Disorders / Q000453:epidemiology