title: Impact of Sensory Impairments on Functional Disability in Adults With Arthritis.
abstract: BACKGROUND
  Mobility is reduced in people with sensory impairments and those with arthritis. The combined impact of these conditions may be underappreciated. This study examines the associations between impairments in vision, hearing, and balance and functional ability in adults with versus without arthritis.
  
  
  METHODS
  Using National Health and Nutrition Examination Survey data from 1999-2004, arthritis status, functional ability, and sensory impairments (vision, hearing, and balance) were assessed from self-reported responses by 6,654 individuals aged ≥50 years (mean age, 63.4 years; 46.3% male). Multivariable regression analyses, conducted in 2014, assessed the associations between sensory impairment and arthritis on functional ability and mobility.
  
  
  RESULTS
  Among study participants, 41.8% reported having arthritis; of these, 27.1%, 44.9%, and 35.1% reported impaired vision, hearing, or balance, respectively. Having multiple sensory impairments was significantly associated with reduced functional ability in people with arthritis; individuals with three sensory impairments reported the highest levels of disability for all functional domains (compared with no impairment; lower extremity mobility, 80.2% vs 39.1%; general physical activities, 94.7% vs 75.9%; activities of daily living, 69.7% vs 27.2%; instrumental activities of daily living, 77.2% vs 37.4%; leisure and social activities, 66.3% vs 30.6%; impaired gait speed, 48.1% vs 16.3%; all p<0.001). Importantly, visual deficits, in combination with arthritis, had the greatest impact on mobility, with odds of impaired mobility at least twice as high as for individuals without arthritis.
  
  
  CONCLUSIONS
  Addressing sensory deficits, especially difficulties with vision, may improve functional ability, which may be particularly helpful for adults with arthritis.
authors.affiliation: Division of Epidemiology and Clinical Applications, Intramural Research Program, National Eye Institute, NIH, Bethesda, Maryland. Electronic address: diana.fisher@nih.gov.
authors.forename: Diana E
authors.initials: DE
authors.lastname: Fisher
authors.affiliation: Intramural Research Program, National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Ward
authors.affiliation: Epidemiology and Statistics Program, Division of Scientific Programs, National Institute on Deafness and Other Communication Disorders, NIH, Bethesda, Maryland.
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Hoffman
authors.affiliation: Epidemiology and Statistics Program, Division of Scientific Programs, National Institute on Deafness and Other Communication Disorders, NIH, Bethesda, Maryland.
authors.forename: Chuan-Ming
authors.initials: CM
authors.lastname: Li
authors.affiliation: Division of Epidemiology and Clinical Applications, Intramural Research Program, National Eye Institute, NIH, Bethesda, Maryland.
authors.forename: Mary Frances
authors.initials: MF
authors.lastname: Cotch
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001168:Arthritis / Q000150:complications / Q000503:physiopathology*; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D006311:Hearing Disorders / Q000150:complications / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D004856:Postural Balance; D012044:Regression Analysis; D012678:Sensation Disorders / Q000150:complications / Q000503:physiopathology*; D014481:United States; D014786:Vision Disorders / Q000150:complications / Q000503:physiopathology