title: Gender-specific associations of vision and hearing impairments with adverse health outcomes in older Japanese: a population-based cohort study.
abstract: BACKGROUND
  Several epidemiological studies have shown that self-reported vision and hearing impairments are associated with adverse health outcomes (AHOs) in older populations; however, few studies have used objective sensory measurements or investigated the role of gender in this association. Therefore, we examined the association of vision and hearing impairments (as measured by objective methods) with AHOs (dependence in activities of daily living or death), and whether this association differed by gender.
  
  
  METHODS
  From 2005 to 2006, a total of 801 residents (337 men and 464 women) aged 65 years or older of Kurabuchi Town, Gunma, Japan, participated in a baseline examination that included vision and hearing assessments; they were followed up through September 2008. Vision impairment was defined as a corrected visual acuity of worse than 0.5 (logMAR = 0.3) in the better eye, and hearing impairment was defined as a failure to hear a 30 dB hearing level signal at 1 kHz in the better ear. Information on outcomes was obtained from the town hall and through face-to-face home visit interviews. We calculated the risk ratios (RRs) of AHOs for vision and hearing impairments according to gender.
  
  
  RESULTS
  During a mean follow-up period of 3 years, 34 men (10.1%) and 52 women (11.3%) had AHOs. In both genders, vision impairment was related to an elevated risk of AHOs (multi-adjusted RR for men and women together = 1.60, 95% CI = 1.05-2.44), with no statistically significant interaction between the genders. In contrast, a significant association between hearing impairment and AHOs (multi-adjusted RR = 3.10, 95% CI = 1.43-6.72) was found only in the men.
  
  
  CONCLUSIONS
  In this older Japanese population, sensory impairments were clearly associated with AHOs, and the association appeared to vary according to gender. Gender-specific associations between sensory impairments and AHOs warrant further investigation.
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, Keio University, Shinjuku-ku, Tokyo, Japan. di065051@sc.itc.keio.ac.jp
authors.forename: Takehiro
authors.initials: T
authors.lastname: Michikawa
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nishiwaki
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Kikuchi
authors.forename: Makiko
authors.initials: M
authors.lastname: Nakano
authors.forename: Satoko
authors.initials: S
authors.lastname: Iwasawa
authors.forename: Keiko
authors.initials: K
authors.lastname: Asakura
authors.forename: Ai
authors.initials: A
authors.lastname: Milojevic
authors.forename: Kunio
authors.initials: K
authors.lastname: Mizutari
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Saito
authors.forename: Susumu
authors.initials: S
authors.lastname: Ishida
authors.forename: Tomonori
authors.initials: T
authors.lastname: Okamura
authors.forename: Toru
authors.initials: T
authors.lastname: Takebayashi
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006304:Health Status; D034381:Hearing Loss / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D007564:Japan; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D015996:Survival Rate; D014786:Vision Disorders / Q000150:complications* / Q000453:epidemiology / Q000523:psychology