Aging
Joint Associations Between Sensory Impairment, Cognition, and Mortality: A Population-Based Study Jordan Weiss* Jordan Weiss NYU Grossman School of Medicine
Vision and hearing impairment are common in later life and have each been linked to adverse cognitive and survival outcomes. However, the joint associations of dual sensory impairment with cognitive decline and mortality, accounting for their interdependence, are not well characterized. We used 12 waves (2000–2022) of the Health and Retirement Study, a nationally representative longitudinal cohort of United States adults aged 50 years or older. The analytic sample included 16 234 adults aged 51 years or older who were dementia-free at baseline and followed biennially. Vision and hearing impairment were self-reported and classified as none, vision only, hearing only, or dual impairment. Cognitive function was assessed using a 27-point global cognitive score administered repeatedly over follow-up. Mortality was ascertained using national death records and exit interviews. Linear mixed-effects models estimated cognitive trajectories, Cox proportional hazards models estimated mortality risk, and joint longitudinal-survival models accounted for informative censoring due to death. Compared with participants without sensory impairment, those with dual sensory impairment had lower baseline cognitive scores and significantly faster cognitive decline over follow-up. Dual sensory impairment was also associated with substantially higher mortality risk than either vision or hearing impairment alone, independent of age, sex, race and ethnicity, and educational attainment. Joint models indicated that accelerated cognitive decline partially explained the excess mortality associated with dual sensory impairment. In this nationally representative cohort, dual sensory impairment was associated with both accelerated cognitive decline and increased mortality risk beyond single sensory impairments. These findings suggest that co-occurring vision and hearing loss may represent an important, potentially modifiable target for promoting cognitive health and longevity in aging populations.
