title: Association of hearing impairment with declines in physical functioning and the risk of disability in older adults.
abstract: BACKGROUND
  Identifying factors associated with functional declines in older adults is important given the aging of the population. We investigated if hearing impairment is independently associated with objectively measured declines in physical functioning in a community-based sample of older adults.
  
  
  METHODS
  Prospective observational study of 2,190 individuals from the Health, Aging, and Body Composition study. Participants were followed annually for up to 11 visits. Hearing was measured with pure-tone audiometry. Physical functioning and gait speed were measured with the Short Physical Performance Battery (SPPB). Incident disability and requirement for nursing care were assessed semiannually through self-report.
  
  
  RESULTS
  In a mixed-effects model, greater hearing impairment was associated with poorer physical functioning. At both Visit 1 and Visit 11, SPPB scores were lower in individuals with mild (10.14 [95% CI 10.04-10.25], p < .01; 7.35 [95% CI 7.12-7.58], p < .05) and moderate or greater hearing impairment (10.04 [95% CI 9.90-10.19], p < .01; 7.00 [95% CI 6.69-7.32], p < .01) than scores in normal hearing individuals (10.36 [95% CI 10.26-10.46]; 7.71 [95% CI 7.49-7.92]). We observed that women with moderate or greater hearing impairment had a 31% increased risk of incident disability (Hazard ratio [HR] =1.31 [95% CI 1.08-1.60], p < .01) and a 31% increased risk of incident nursing care requirement (HR = 1.31 [95% CI 1.05-1.62], p = .02) compared to women with normal hearing.
  
  
  CONCLUSIONS
  Hearing impairment is independently associated with poorer objective physical functioning in older adults, and a 31% increased risk for incident disability and need for nursing care in women.
authors.affiliation: Johns Hopkins University School of Medicine, Baltimore, Maryland. Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: David S
authors.initials: DS
authors.lastname: Chen
authors.affiliation: Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.
authors.forename: Joshua
authors.initials: J
authors.lastname: Betz
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
authors.forename: Kristine
authors.initials: K
authors.lastname: Yaffe
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, California.
authors.forename: Hilsa N
authors.initials: HN
authors.lastname: Ayonayon
authors.affiliation: Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors.forename: Stephen
authors.initials: S
authors.lastname: Kritchevsky
authors.affiliation: Laboratory of Epidemiology and Population Sciences and Intramural Research Program, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, Maryland. Epidemiology Group, School of Medicine and Dentistry, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, UK.
authors.forename: Kathryn R
authors.initials: KR
authors.lastname: Martin
authors.affiliation: Laboratory of Epidemiology and Population Sciences and Intramural Research Program, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, Maryland.
authors.forename: Tamara B
authors.initials: TB
authors.lastname: Harris
authors.affiliation: Department of Epidemiology and Biostatistics, State University of New York Downstate Medical Center, Brooklyn, New York.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Purchase-Helzner
authors.affiliation: Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Satterfield
authors.affiliation: Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland. Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Qian-Li
authors.initials: QL
authors.lastname: Xue
authors.affiliation: Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania. Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Sheila
authors.initials: S
authors.lastname: Pratt
authors.affiliation: Intramural Research Program, National Institute on Aging, Baltimore, Maryland.
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: Simonsick
authors.affiliation: Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland. Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. flin1@jhmi.edu.
authors.forename: Frank R
authors.initials: FR
authors.lastname: Lin
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001301:Audiometry, Pure-Tone; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D034381:Hearing Loss / Q000453:epidemiology* / Q000451:nursing; D006801:Humans; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D057566:Self Report; D013714:Tennessee / Q000453:epidemiology
keywords: Epidemiology.; Physical function; Physical performance