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Global Sensory Impairment Predicts Morbidity and Mortality in Older U.S. Adults.

ABSTRACT: OBJECTIVES:To evaluate global sensory impairment (GSI, an integrated measure of sensory dysfunction) as a predictor of physical function, cognition, overall health, and mortality. DESIGN:Prospective study. SETTING:The National Social Life, Health, and Aging Project. PARTICIPANTS:A national probability sample of 3,005 home-dwelling older U.S. adults assessed at baseline (2005-06) and 5-year follow-up (2010-11). MEASUREMENTS:Gait speed, activity, disability, cognition, overall health, 5-year mortality. RESULTS:At baseline, older adults with worse GSI were slower (Timed Up and Go times: odds ratio (OR) = 1.32, 95% confidence interval (CI) = 1.17-1.50) and had more activity of daily living deficits (?2: OR = 1.26, 95% CI = 1.10-1.46). Five years later, they were still slower (timed walk: OR = 1.22, 95% CI = 1.05-1.42), had more disabilities (?2 instrumental activities of daily living; OR = 1.45, 95% CI = 1.23-1.70), were less active (daytime activity according to accelerometry: ? = -2.7, 95% CI = -5.2 to -0.2), had worse cognitive function (Montreal Cognitive Assessment; ? = -0.64, 95% CI = -0.84 to -0.44), more likely to have poorer overall health (OR = 1.16, 95% CI = 1.03-1.31) and lose weight (>10%: OR = 1.31, 95% CI = 1.04-1.64), and have died (OR = 1.45, 95% CI = 1.19-1.76). All analyses were adjusted for relevant confounders at baseline, including age, sex, race and ethnicity, education, smoking, problem drinking, body mass index, comorbidities, and cognitive function. CONCLUSION:GSI predicts impaired physical function, cognitive dysfunction, significant weight loss, and mortality 5 years later in older U.S. adults. Multisensory evaluation may identify vulnerable individuals, offering the opportunity for early intervention to mitigate adverse outcomes.

SUBMITTER: Pinto JM

PROVIDER: S-EPMC6317884 | biostudies-literature | 2017 Dec

REPOSITORIES: biostudies-literature

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Global Sensory Impairment Predicts Morbidity and Mortality in Older U.S. Adults.

Pinto Jayant M JM Wroblewski Kristen E KE Huisingh-Scheetz Megan M Correia Camil C Lopez Kevin J KJ Chen Rachel C RC Kern David W DW Schumm Philip L PL Dale William W McClintock Martha K MK

Journal of the American Geriatrics Society 20170924 12

<h4>Objectives</h4>To evaluate global sensory impairment (GSI, an integrated measure of sensory dysfunction) as a predictor of physical function, cognition, overall health, and mortality.<h4>Design</h4>Prospective study.<h4>Setting</h4>The National Social Life, Health, and Aging Project.<h4>Participants</h4>A national probability sample of 3,005 home-dwelling older U.S. adults assessed at baseline (2005-06) and 5-year follow-up (2010-11).<h4>Measurements</h4>Gait speed, activity, disability, cog ...[more]

PMID: 28942611

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Project description:ObjectivesTo examine the association between self-reported vision impairment (VI), hearing impairment (HI), and dual-sensory impairment (DSI), stratified by dementia status, on hospital admissions, hospice use, and healthcare costs.DesignRetrospective analysis.SettingMedicare Current Beneficiary Survey from 1999 to 2006.ParticipantsRotating panel of community-dwelling Medicare beneficiaries, aged 65 years and older (N = 24 009).MeasurementsVI and HI were ascertained by self-report. Dementia status was determined by self-report or diagnosis codes in claims data. Primary outcomes included any inpatient admission over a 2-year period, hospice use over a 2-year period, annual Medicare fee-for-service costs, and total healthcare costs (which included information from Medicare claims data and other self-reported payments).ResultsSelf-reported DSI was present in 30.2% (n = 263/871) of participants with dementia and 17.8% (n = 4112/23 138) of participants without dementia. In multivariable logistic regression models, HI, VI, or DSI was generally associated with increased odds of hospitalization and hospice use regardless of dementia status. In a generalized linear model adjusted for demographics, annual total healthcare costs were greater for those with DSI and dementia compared to those with DSI without dementia ($28 875 vs $3340, respectively). Presence of any sensory impairment was generally associated with higher healthcare costs. In a model adjusted for demographics, Medicaid status, and chronic medical conditions, DSI compared with no sensory impairment was associated with a small, but statistically significant, difference in total healthcare spending in those without dementia ($1151 vs $1056; P < .001) but not in those with dementia ($11 303 vs $10 466; P = .395).ConclusionOlder adults with sensory and cognitive impairments constitute a particularly prevalent and vulnerable population who are at increased risk of hospitalization and contribute to higher healthcare spending. J Am Geriatr Soc 67:1617-1624, 2019.

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Global Sensory Impairment Predicts Morbidity and Mortality in Older U.S. Adults.

Publications

Global Sensory Impairment Predicts Morbidity and Mortality in Older U.S. Adults.

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