title: Impairments in hearing and vision impact on mortality in older people: the AGES-Reykjavik Study.
abstract: OBJECTIVE
  to examine the relationships between impairments in hearing and vision and mortality from all-causes and cardiovascular disease (CVD) among older people.
  
  
  METHODS
  population-based cohort study.
  
  
  METHODS
  the study population included 4,926 Icelandic individuals, aged ≥67 years, 43.4% male, who completed vision and hearing examinations between 2002 and 2006 in the Age, Gene/Environment Susceptibility-Reykjavik Study (AGES-RS) and were followed prospectively for mortality through 2009.
  
  
  METHODS
  participants were classified as having 'moderate or greater' degree of impairment for vision only (VI), hearing only (HI), and both vision and hearing (dual sensory impairment, DSI). Cox proportional hazard regression, with age as the time scale, was used to calculate hazard ratios (HR) associated with impairment and mortality due to all-causes and specifically CVD after a median follow-up of 5.3 years.
  
  
  RESULTS
  the prevalence of HI, VI and DSI were 25.4, 9.2 and 7.0%, respectively. After adjusting for age, significantly (P < 0.01) increased mortality from all causes, and CVD was observed for HI and DSI, especially among men. After further adjustment for established mortality risk factors, people with HI remained at higher risk for CVD mortality [HR: 1.70 (1.27-2.27)], whereas people with DSI remained at higher risk of all-cause mortality [HR: 1.43 (1.11-1.85)] and CVD mortality [HR: 1.78 (1.18-2.69)]. Mortality rates were significantly higher in men with HI and DSI and were elevated, although not significantly, among women with HI.
  
  
  CONCLUSIONS
  older men with HI or DSI had a greater risk of dying from any cause and particularly cardiovascular causes within a median 5-year follow-up. Women with hearing impairment had a non-significantly elevated risk. Vision impairment alone was not associated with increased mortality.
authors.affiliation: Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Diana
authors.initials: D
authors.lastname: Fisher
authors.forename: Chuan-Ming
authors.initials: CM
authors.lastname: Li
authors.forename: May S
authors.initials: MS
authors.lastname: Chiu
authors.forename: Christa L
authors.initials: CL
authors.lastname: Themann
authors.forename: Hannes
authors.initials: H
authors.lastname: Petersen
authors.forename: Friðbert
authors.initials: F
authors.lastname: Jónasson
authors.forename: Pálmi V
authors.initials: PV
authors.lastname: Jónsson
authors.forename: Johanna Eyrun
authors.initials: JE
authors.lastname: Sverrisdottir
authors.forename: Melissa
authors.initials: M
authors.lastname: Garcia
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.forename: Lenore J
authors.initials: LJ
authors.lastname: Launer
authors.forename: Gudny
authors.initials: G
authors.lastname: Eiriksdottir
authors.forename: Vilmundur
authors.initials: V
authors.lastname: Gudnason
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Hoffman
authors.forename: Mary Frances
authors.initials: MF
authors.lastname: Cotch
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D005260:Female; D006309:Hearing; D006311:Hearing Disorders / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D019986:Persons with Hearing Disabilities; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014786:Vision Disorders / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D014785:Vision, Ocular; D019987:Persons with Visual Disabilities
keywords: AGES-Reykjavik study; all-cause mortality; cardiovascular disease mortality; dual sensory impairment; hearing; older people; vision