Supported by Grants AG05407, AR35582, AG05394, AR35584, and AR35583 from the Public Health Service, National Institutes of Health, Bethesda, Maryland. Support for Dr. Mangione was provided by the UCLA Center for Health Improvement in Minority Elders/Resource Centers for Minority Aging Research, National Institutes of Health, National Institute of Aging (AG-02–004).
Vision Impairment and Combined Vision and Hearing Impairment Predict Cognitive and Functional Decline in Older Women
Version of Record online: 18 NOV 2004
Journal of the American Geriatrics Society
Volume 52, Issue 12, pages 1996–2002, December 2004
How to Cite
Lin, M. Y., Gutierrez, P. R., Stone, K. L., Yaffe, K., Ensrud, K. E., Fink, H. A., Sarkisian, C. A., Coleman, A. L. and Mangione, C. M. (2004), Vision Impairment and Combined Vision and Hearing Impairment Predict Cognitive and Functional Decline in Older Women. Journal of the American Geriatrics Society, 52: 1996–2002. doi: 10.1111/j.1532-5415.2004.52554.x
This paper was presented at the 2002 Society of General Internal Medicine National Meeting, Atlanta, Georgia.
- Issue online: 18 NOV 2004
- Version of Record online: 18 NOV 2004
- vision impairment;
- hearing impairment;
- cognitive status;
- functional status;
Objectives: To determine the association between vision and hearing impairment and subsequent cognitive and functional decline in community-residing older women.
Design: Prospective cohort study.
Setting: Four metropolitan areas of the United States.
Participants: A total of 6,112 women aged 69 and older participating in the Study of Osteoporotic Fractures (SOF) between 1992 and 1994.
Measurements: Five thousand three hundred forty-five participants had hearing measured, 1,668 had visual acuity measured, and 1,636 had both measured. Visual impairment was defined as corrected vision worse than 20/40. Hearing impairment was defined as the inability to hear a tone of 40 dB or greater at 2,000 hertz. Participants completed the modified Mini-Mental State Examination and/or a functional status assessment at baseline and follow-up. Cognitive and functional decline were defined as the amount of decline from baseline to follow-up that exceeded the observed average change in scores by at least 1 standard deviation.
Results: About one-sixth (15.7%) of the sample had cognitive decline; 10.1% had functional decline. In multivariate models adjusted for sociodemographic characteristics and chronic conditions, vision impairment at baseline was associated with cognitive (odds ratio (OR)=1.78, 95% confidence interval (CI)=1.21–2.61) and functional (OR=1.79, 95% CI=1.15–2.79) decline. Hearing impairment was not associated with cognitive or functional decline. Combined impairment was associated with the greatest odds for cognitive (OR=2.19, 95% CI=1.26–3.81) and functional (OR=1.87, 95% CI=1.01–3.47) decline.
Conclusion: Sensory impairment is associated with cognitive and functional decline in older women. Studies are needed to determine whether treatment of vision and hearing impairment can decrease the risk for cognitive and functional decline.