Comparative impact of hearing and vision impairment on subsequent functioning

OBJECTIVES: The purpose of this study was to compare independent impacts of two levels of self-reported hearing and vision impairment on subsequent di sability, physical functioning, mental health, and social functioning. DESIGN: A 1-year prospective cohort study. SETTING: San Francisco Bay Area, California. PARTICIPANTS: Two thousand four hundred forty-two community-dwelling men an d women age 50 to 102 from the Alameda County Study (California). MEASUREMENTS: Hearing and vision impairment were assessed in 1994. Outcomes , measured in 1995, included physical disability (activities of daily livin g, instrumental activities of daily living, physical performance, mobility, and lack of participation in activities), mental health (self-assessed, ma jor depressive episode), and social functioning (feeling left out, feeling lonely, hard to feel close to others, inability to pay attention). All 1995 outcomes were adjusted for baseline 1994 values. RESULTS: Both impairments had strong independent impacts on subsequent func tioning. Vision impairment exerted a more wide-ranging impact on functional status, ranging from physical disability to social functioning. However, t he results also highlighted the importance of hearing impairment, even when mild. CONCLUSIONS: These impairments can be partially ameliorated through prevent ion, assessment, and treatment strategies. Greater attention to sensory imp airments by clinicians, patients, public health advocates, and researchers is needed to enhance functioning in older adults.