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: β = -2.7, 95% CI = -5.2 to -0.2), had worse cognitive function (Montreal Cognitive Assessment; β = -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.

Keywords: activity; aging; cognition; disability; health outcomes; mortality; sensory function; weight loss.

Figure 1. Global Sensory Impairment Predicts Worse Mobility and Function, Weight Loss, and Increased Mortality 5 Years Later (Mean probability, adjusting for baseline covariates; see Supplementary Material Tables S4 and S6 for full models)

The probability of taking more than 4 seconds on the timed walk increases from 0.48 for those with the lowest GSI score to 0.68 for those with the highest GSI score. The probability of having 2 or more IADL difficulties increases from 0.16 for those with the lowest GSI score to 0.47 for those with the highest GSI score, while the probability of having more than 10% weight loss increases from 0.08 to 0.25. The probability of 5-year mortality increases from 0.07 for those with the lowest GSI score to 0.27 for those with the highest GSI score. The gray shaded areas represent 95% confidence bounds for the estimates.