Disparities in mortality outcomes among older adults with communication disabilities using the National Health and Aging Trends Study

Objective: To examine if a nationally representative population of older adults with communication disabilities (CDs) have a higher risk of mortality when compared to older adults without these disabilities, independent of sociodemographic, health, and other disability characteristics.

Design: Retrospective, cohort study. We conducted a survival analysis using multivariable Cox-proportional hazards regression, adjusting for sociodemographic, health, and other disability characteristics.

Setting: Annual data from the National Health and Aging Trends Study (NHATS) (Rounds 2011-2020).

Participants: A nationally representative sample of Medicare beneficiaries 65 years and older with and without any receptive or expressive communication difficulties.

Interventions: Not applicable.

Main outcome measure: Hazard ratios (HR) demonstrated the independent mortality risk by CD, over a ten-year period.

Results: The presence of CD was associated with an increased hazard of dying (HR: 2.79, 95% CI: 2.51-3.10). After adjustment, older adults with CD had a 1.46 times higher risk of death compared to those without CD (95% CI: 1.31-1.62).

Conclusions: Older adults with communication disabilities face a significantly higher risk of mortality, independent of health, sociodemographic, and other disability characteristics. These findings underscore the need to include this group when counting people with disability in national surveys, and explore potential factors unique to CDs including access to high quality healthcare contributing to disparate mortality outcomes.