Ge Shaoqing, Pan Wei, Wu Bei, Plassman Brenda L, Dong XinQi, McConnell Eleanor S
Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA, United States.
Duke University School of Nursing, Durham, NC, United States.
Front Neurosci. 2023 Jan 9;16:1092297. doi: 10.3389/fnins.2022.1092297. eCollection 2022.
Multiple studies have reported that hearing and vision impairment are linked to cognitive decline. Yet little is known about factors that may influence the association between sensory impairment and cognitive decline. This study examined if loneliness mediates or moderates the impact of sensory impairment on cognitive decline as individuals age.
This was a longitudinal study using data from the Health and Retirement Study (HRS) and The Aging, Demographics, and Memory Study (ADAMS) ( = 243). We used one timepoint of hearing and vision (ADAMS 2006-2008), one timepoint of loneliness (HRS 2006-2008), and five waves of cognition (HRS 2006-2014). Hearing impairment was defined by an inability to hear pure-tone stimuli of 25 dB at frequencies between 0.5 and 4.0 kHz in either ear. Visual impairment was defined as having corrected binocular vision worse than 20/40. Longitudinal parallel-process (LPP) analysis was conducted at a significance level of α = 0.05 (one-tailed).
Loneliness moderated but did not mediate the association between visual impairment and the rate of cognitive decline (standardized β =-0.108, < 0.05). No moderation or mediation effect of loneliness was found for the association between hearing impairment and cognitive decline. Both vision and hearing impairment were significantly associated with increased severity of loneliness.
Visual impairment combined with an elevated level of loneliness may produce a more synergistic, deleterious impact on older adults' cognitive function than visual impairment alone. This study highlights the importance of promoting a healthy social and psychological status for older adults with sensory impairment.
多项研究报告称，听力和视力障碍与认知能力下降有关。然而，对于可能影响感觉障碍与认知能力下降之间关联的因素，我们知之甚少。本研究探讨了随着个体年龄增长，孤独感是否介导或调节感觉障碍对认知能力下降的影响。
这是一项纵向研究，使用了健康与退休研究（HRS）和老龄化、人口统计学与记忆研究（ADAMS）（n = 243）的数据。我们使用了一个听力和视力时间点（ADAMS 2006 - 2008）、一个孤独感时间点（HRS 2006 - 2008）以及五波认知能力数据（HRS 2006 - 2014）。听力障碍定义为双耳在0.5至4.0千赫兹频率下无法听到25分贝的纯音刺激。视力障碍定义为矫正后的双眼视力低于20/40。纵向平行过程（LPP）分析在显著性水平α = 0.05（单尾）下进行。
孤独感调节但未介导视力障碍与认知能力下降速率之间的关联（标准化β = -0.108，p < 0.05）。未发现孤独感对听力障碍与认知能力下降之间的关联有调节或介导作用。视力和听力障碍均与孤独感严重程度增加显著相关。
与单纯视力障碍相比，视力障碍与较高水平的孤独感相结合可能对老年人的认知功能产生更协同、有害的影响。本研究强调了为有感觉障碍的老年人促进健康的社会和心理状态的重要性。
