title: Concurrent visual and hearing impairment and risk of mortality: the National Health Interview Survey.
abstract: OBJECTIVE
  To determine the association between reported concurrent visual and hearing impairment and risk of mortality.
  
  
  METHODS
  Annual cross-sectional multistage area probability surveys of the US civilian noninstitutionalized population living at addressed dwellings were conducted by the National Center for Health Statistics, Hyattsville, Md. Mortality linkage with the National Death Index of participants from 1986 to 1994 was performed through 1997. Complete reported visual and hearing impairment data and survival status were available for 116 796 adults aged 18 years and older. A total of 3620 participants reported visual impairment only, 12 330 reported hearing impairment only, and 1461 reported concurrent visual and hearing impairment.
  
  
  METHODS
  Risk of mortality.
  
  
  RESULTS
  Mortality linkage identified 8949 deaths with an average follow-up of 7.0 years. After controlling for survey design, age, marital status, educational level, self-rated health, and number of nonocular and nonauditory conditions, white participants and "other-race" participants, but not African American participants, reporting concurrent visual and hearing impairment had significantly increased risk of mortality in comparison with their counterparts reporting no impairment (white participants: hazard ratio [HR] = 1.23, 95% confidence interval [CI], 1.04-1.46 for men and HR = 1.63, 95% CI, 1.37-1.93 for women; African American participants: HR = 1.50, 95% CI, 0.94-2.40 for men and HR = 0.92, 95% CI, 0.51-1.63 for women; participants of other races: HR = 2.47, 95% CI, 1.33-4.57 for men and HR = 2.23, 95% CI, 1.01-4.90 for women). Risk of mortality was generally greater for participants reporting concurrent impairment as compared with that for participants reporting either visual impairment alone or hearing impairment alone.
  
  
  CONCLUSIONS
  In the United States, white persons and those of other races, but not African American persons, reporting concurrent visual and hearing impairment have an increased risk of mortality. Reported concurrent impairment is an independent predictor of mortality among white persons and those of other races for both men and women.
authors.affiliation: Bascom Palmer Eye Institute, Department of Epidemiology and Public Health, University of Miami School of Medicine, 900 NW 17th Street, Miami, FL 33136, USA. blam@med.miami.edu
authors.forename: Byron L
authors.initials: BL
authors.lastname: Lam
authors.forename: David J
authors.initials: DJ
authors.lastname: Lee
authors.forename: Orlando
authors.initials: O
authors.lastname: Gómez-Marín
authors.forename: D Diane
authors.initials: DD
authors.lastname: Zheng
authors.forename: Alberto J
authors.initials: AJ
authors.lastname: Caban
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D044383:Black People; D001766:Blindness / Q000150:complications* / Q000401:mortality*; D003638:Deafness / Q000150:complications* / Q000401:mortality*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009309:National Center for Health Statistics, U.S.; D019986:Persons with Hearing Disabilities / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*; D044465:White People; D001741:Black or African American