Association Between Dual Sensory Impairment, Hospitalization, and Burden of Disease

Huddle, Matthew G.; Deal, Jennifer A.; Swenor, Bonnielin K.; Genther, Dane J.; Lin, Frank R.

doi:10.1111/jgs.14210

Cited by 27 publications

(29 citation statements)

References 10 publications

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“…It is also associated with reduced quality of life, reduced cognitive function and increased loneliness . However, thus far, it remains almost unknown whether DSI is associated with healthcare use (HCU) among older adults . Therefore, the aim of our study was to clarify whether DSI is associated with increased HCU based on a nationally representative sample of community‐dwelling individuals aged ≥40 years in Germany.…”

Section: Introductionmentioning

confidence: 99%

Dual sensory impairment and healthcare use: Findings from a nationally representative sample

Hajek

König

2020

Geriatrics Gerontology Int

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Aim Dual sensory impairment (DSI) is a common phenomenon in later life. However, only a few studies investigated whether DSI is associated with healthcare use. Therefore, our purpose was to determine whether DSI is associated with healthcare use among older adults. Methods Data were taken from the most recent sixth wave of the German Ageing Survey. When self‐reported hearing problems and visual impairment were both present, individuals were classified as dual sensory impaired. The frequency of general practitioner (GP) visits, frequency of specialist visits and hospitalization were used as outcome measures. Covariates (mainly based on self‐reports) were selected based on Andersen's behavioral model. In total, 5081 observations were in our analytical sample. Results Among individuals with DSI, mean ± SD number of GP visits was 4.4 ± 4.7, mean ± SD number of specialist visits was 3.7 ± 5.0, and 23.2% were hospitalized in the past 12 months. Among individuals without sensory impairment, mean ± SD number of GP visits was 3.0 ± 3.6, mean ± SD number of specialist visits was 2.4 ± 3.4, and 17% were hospitalized in the past 12 months. Negative binomial regressions revealed that the presence of DSI was associated with increased specialist visits (incidence rate ratio = 1.17 [95% confidence interval: 1.06–1.28]), whereas it was not associated with GP visits and hospitalization. Conclusions Even after adjusting for several covariates, individuals with DSI had higher specialist visits than individuals without DSI. As the presence of DSI is associated with an increased economic burden, efforts to prevent or delay DSI may be beneficial. Geriatr Gerontol Int ••; ••: ••–•• Geriatr Gerontol Int 2020; ••: ••–••.

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Section: Introductionmentioning

confidence: 99%

Dual sensory impairment and healthcare use: Findings from a nationally representative sample

Hajek

König

2020

Geriatrics Gerontology Int

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“…While HI, VI from glaucoma, and DI are independently associated with functional and cognitive decline, there is conflicting evidence on whether DI results in greater difficulty with physical function, cognitive function, and worse mental health than VI or HI alone. [ 23 , 24 ] Additionally, to our knowledge, no prior studies have examined the role of glaucomatous VF loss as the cause of VI in DI. In this study of glaucoma and HI, we hypothesized that older individuals with VI from glaucoma and concurrent HI would be more likely to report difficulties with physical functioning and communication, perform poorer on standardized tests of cognition, and have worse mental health than those who have single sensory impairment.…”

Section: Introductionmentioning

confidence: 99%

Dual sensory impairment: The association between glaucomatous vision loss and hearing impairment and function

et al. 2018

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BackgroundHearing impairment, vision impairment, and dual impairment (both hearing and vision impairment), have been independently associated with functional and cognitive decline. In prior studies of dual impairment, vision impairment is generally not defined or defined by visual acuity alone. Glaucoma is a leading cause of blindness and does not affect visual acuity until late in the disease; instead, visual field loss is used to measure vision impairment from glaucoma.ObjectiveTo examine the effect of glaucomatous visual field loss and hearing impairment on function.DesignCross-sectional.SettingHospital-based clinic in Baltimore, Maryland.Subjects220 adults, ≥55 years presenting to the glaucoma clinic.MethodsVision impairment was defined as mean deviation on visual field testing worse than -5 decibels in the better eye, and hearing impairment was defined as pure tone average worse than 25 decibels on threshold audiometry testing in the better ear. Standardized questionnaires were used to assess functional status.ResultsFive participants were excluded for incomplete testing, leaving 32 with vision impairment only, 63 with hearing impairment only, 42 with dual impairment, and 78 controls with no hearing impairment or vision impairment. Participants with dual impairment were more likely to be older and non-White. Dual impairment was associated with significantly more severe driving limitation and more difficulty with communication compared to those without sensory impairment when adjusted for age, race, gender and number of comorbidities.ConclusionOlder individuals with glaucoma and hearing loss seem to have generally poorer functioning than those with single sensory loss. Health professionals should consider visual field loss as a type of vision impairment when managing patients with dual impairment.

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“…HI and VI are independently associated with adverse health outcomes, including hospitalization, cognitive impairment, poor physical functioning, reduced quality of life, and increased mortality . Compared to either HI or VI alone, DSI leads to higher rates of functional dependence and hospitalization . Sensory and cognitive impairments are also independently associated with increased healthcare cost .…”

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confidence: 99%

“…[6][7][8][9] Compared to either HI or VI alone, DSI leads to higher rates of functional dependence and hospitalization. 10,11 Sensory and cognitive impairments are also independently associated with increased healthcare cost. 5,[12][13][14][15] The estimated direct medical cost for HI alone ranges from $3.3 billion to $12.8 billion per year, and the total monetary cost of dementia in 2010 was estimated to be between $157 billion and $215 billion.…”

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confidence: 99%

Association of Sensory and Cognitive Impairment With Healthcare Utilization and Cost in Older Adults

Deardorff

Liu

Sloane

et al. 2019

J American Geriatrics Society

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OBJECTIVES To 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. DESIGN Retrospective analysis. SETTING Medicare Current Beneficiary Survey from 1999 to 2006. PARTICIPANTS Rotating panel of community‐dwelling Medicare beneficiaries, aged 65 years and older (N = 24 009). MEASUREMENTS VI 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). RESULTS Self‐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). CONCLUSION Older 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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Association Between Dual Sensory Impairment, Hospitalization, and Burden of Disease

Cited by 27 publications

References 10 publications

Dual sensory impairment and healthcare use: Findings from a nationally representative sample

Dual sensory impairment and healthcare use: Findings from a nationally representative sample

Dual sensory impairment: The association between glaucomatous vision loss and hearing impairment and function

Association of Sensory and Cognitive Impairment With Healthcare Utilization and Cost in Older Adults

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