PTOTSLPCohortArchives of physical medicine and rehabilitation2025

Disparities in Mortality Outcomes Among Older Adults With Communication Disabilities Using the National Health and Aging Trends Study.

Jennifer Y Oshita, Nicholas S Reed, Peter W Callas and 2 others

PMID 39716547

WHAT IT FOUND

Older adults with communication disabilities had a 46% higher risk of death over ten years than those without, even after accounting for health and other disabilities.

This risk remained significant for expressive, cognitive, and multiple difficulties, but not for hearing loss alone.

Key findings

01After adjusting for sociodemographic, health, and other disability factors, having any communication disability was associated with a hazard ratio of 1.46 for all-cause mortality over ten years.

02The increased mortality risk remained statistically significant for older adults with expressive-only, cognitive-only, or multiple communication difficulties, but the association for hearing-only difficulties was no longer significant after adjustment.

03Just over one quarter of community-dwelling older adults in the sample had at least one communication difficulty, representing an estimated 6.7 million individuals nationally.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

Hearing and expressive difficulties were self-reported, while cognitive difficulties were measured via testing, creating potential measurement inconsistency. The study did not measure neurologic conditions other than stroke, so it may have missed health factors linked to both communication disabilities and mortality. Dementia cases were excluded at baseline, so findings do not apply to older adults with diagnosed dementia. The study observes association, not causation; it cannot determine if the communication disability itself, or unmeasured barriers to care, drove the mortality risk.

Declared interests

None of the authors have a relevant conflict of interest.

The easy way to misread this

Do not assume that hearing loss alone carries the same adjusted mortality risk as other communication disabilities. After accounting for health and social factors, the increased risk of death for the hearing-only group was not statistically significant, whereas it remained significant for expressive, cognitive, and multiple difficulties.

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