title: Joint Associations of Dual Sensory Impairment and No-Activity Involvement With 1-Year Mortality in Nursing Homes: Results From the SHELTER Study.
abstract: BACKGROUND
  Concurrent vision and hearing impairment, known as dual sensory impairment (DSI), is associated with increased mortality. We aimed to examine individual and joint associations of DSI and involvement in activities with mortality in a large European nursing home study.
  
  
  METHODS
  In total, 2,851 nursing home residents in 59 facilities in eight countries were followed for 1 year in the Services and Health for Elderly in Long TERm Care study. Vision and hearing impairment and average time of involvement in activities were assessed by trained research staff using the interRAI Long Term Care Facilities. Association between DSI and 1-year all-cause mortality was examined using Cox proportional hazards models adjusted for age, sex, facility, diagnoses of coronary heart disease and diabetes mellitus, self-rated health, end-stage disease, and functional and cognitive status. The modifying effect of involvement in activities on the association was investigated by the additive hazard model.
  
  
  RESULTS
  DSI, defined as moderate to severe impairment in both senses, was independently associated with a 35% increased risk of 1-year mortality compared with non-DSI. Residents with DSI who were involved in activities did not have higher mortality, while residents with DSI who were not involved in activities had 51% higher mortality than non-DSI residents who were involved in activities, equivalent to approximately 209 additional deaths per 1,000 person-years (p = .012) due to the interaction between DSI and no involvement in activities.
  
  
  CONCLUSIONS
  DSI is associated with increased mortality at nursing homes when combined with no involvement in activities.
authors.affiliation: Department of Geriatrics, First Faculty of Medicine, Charles University, Prague, Czech Republic. Department of Healthcare Epidemiology, Graduate School of Medicine, Kyoto University, Japan. yamada.yukari.73s@st.kyoto-u.ac.jp.
authors.forename: Yukari
authors.initials: Y
authors.lastname: Yamada
authors.affiliation: AGAPLESION Bethesda Clinic, Competence Centre of Geriatrics, University of Ulm, Ulm, Germany.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Denkinger
authors.affiliation: Center on Aging, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Graziano
authors.initials: G
authors.lastname: Onder
authors.affiliation: EMGO Institute for Health and Care Research, Department of General Practice and Elderly Care Medicine, VU University Medical Centre, Amsterdam, The Netherlands. Elderly Care Research Unit at LUCAS and Center for Sociological Research, KU Leuven, Leuven, Belgium.
authors.forename: Henriëtte G
authors.initials: HG
authors.lastname: van der Roest
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Harriet
authors.initials: H
authors.lastname: Finne-Soveri
authors.affiliation: Center on Aging, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bernabei
authors.affiliation: Department of Geriatrics, First Faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Topinkova
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D015577:Geriatric Assessment; D034381:Hearing Loss / Q000150:complications* / Q000401:mortality*; D006802:Human Activities; D006801:Humans; D008297:Male; D009735:Nursing Homes; D016016:Proportional Hazards Models; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D014786:Vision Disorders / Q000150:complications* / Q000401:mortality*
keywords: Additive hazards model; Dual sensory impairment; Mortality; Nursing home issues