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

Oshita, Jennifer Y; Reed, Nicholas S; Callas, Peter W; Morales, Emmanuel E Garcia; MacLean, Charles D · Arch Phys Med Rehabil · 2025

retrospective_cohort · Level III

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Abstract

To examine whether a nationally representative population of older adults with communication disabilities (CDs) has a higher risk of mortality than older adults without these disabilities, independent of sociodemographic, health, and other disability characteristics. Retrospective, cohort study. We conducted a survival analysis using multivariable Cox proportional hazards regression, adjusting for sociodemographic, health, and other disability characteristics. Annual data from the National Health and Aging Trends Study (Rounds 2011-2020). A nationally representative sample of Medicare beneficiaries aged ≥65 years with and without any receptive or expressive communication difficulties. Not applicable. Hazard ratios demonstrated the independent mortality risk by CD, over a 10-year period. The presence of CD was associated with an increased hazard of dying (hazard ratio, 2.79; 95% CI, 2.51-3.10). After adjustment, older adults with CD had a 1.46 times higher risk of death than those without CD (95% CI, 1.31-1.62). Having a CD in older age increases mortality risk, independent of health, sociodemographic, and other disability characteristics. These findings warrant consideration of communication-specific mechanisms contributing to disparate mortality outcomes in older adulthood.

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