Mao Qingyun, Liang Heting, Yuan Xiaoli, Jiang Zhixia, Hu Rujun, Zhang Yumeng, Li Shuang, Yang Xiaoling
Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, China.
Faculty of Nursing, Zunyi Medical University, Zunyi, Guizhou, China.
Front Public Health. 2025 Apr 3;13:1542789. doi: 10.3389/fpubh.2025.1542789. eCollection 2025.
Although sensory impairment has been identified as a risk factor for cognitive decline, little is known about the underlying mechanisms that connect dual sensory impairment to cognitive ability. This research used a moderated chain-mediated model to investigate the underlying mechanisms behind the association between dual sensory impairment and cognitive ability.
People aged 60 years and older from seven medical institutions, three communities, and five nursing homes in Zunyi city, Guizhou Province, were selected for the study from October 2022 to September 2023 via convenience sampling. Data on demographic characteristics, self-reported hearing and vision loss, and Self-Rating Anxiety Scale (SAS), 15-item Geriatric Depression Scale (GAD-15), Frailty Scale (FRAIL), and Mini-Mental State Examination (MMSE) scores were collected. A moderated chain mediator was used to analyze the underlying mechanisms and pathways of the relationships among anxiety, depression, and cognitive ability in individuals with dual sensory impairment, as well as the moderating role of frailty in this connection.
A total of 7,021 older adults were included, 3,598 (51.25%) of whom were male, with a mean age of 72.01 ± 7.17 years. Dual sensory impairment had a significant direct effect on cognitive ability, with an effect size of -3.134, followed by anxiety and depression, which not only independently mediated the relationship between dual sensory impairment and cognitive ability but also jointly had a chain mediation effect, with mediation effect sizes of -0.766 and -0.182, respectively, and a chain mediation effect size of -0.257. In addition, the interaction effect of dual sensory impairment and frailty was significantly predictive of cognitive ability (effect value = -0.575, < 0.001).
The mechanisms of action between dual sensory impairment, anxiety, depression, cognitive performance, and frailty are shown in this study. This finding also implies that therapies for psychological issues, frailty, and sensory functioning in older adults can preserve their cognitive ability.
尽管感觉障碍已被确定为认知能力下降的一个风险因素，但对于将双重感觉障碍与认知能力联系起来的潜在机制知之甚少。本研究采用了一个有调节的链式中介模型来探究双重感觉障碍与认知能力之间关联背后的潜在机制。
2022年10月至2023年9月，通过便利抽样从贵州省遵义市的7家医疗机构、3个社区和5家养老院选取60岁及以上的人群进行研究。收集了人口统计学特征、自我报告的听力和视力丧失情况、自评焦虑量表（SAS）、15项老年抑郁量表（GAD - 15）、衰弱量表（FRAIL）以及简易精神状态检查表（MMSE）得分的数据。使用有调节的链式中介模型来分析双重感觉障碍个体中焦虑、抑郁与认知能力之间关系的潜在机制和途径，以及衰弱在此关联中的调节作用。
共纳入7021名老年人，其中男性3598名（51.25%），平均年龄为72.01±7.17岁。双重感觉障碍对认知能力有显著的直接效应，效应大小为 - 3.134，其次是焦虑和抑郁，它们不仅独立中介了双重感觉障碍与认知能力之间的关系，还共同产生了链式中介效应，中介效应大小分别为 - 0.766和 - 0.182，链式中介效应大小为 - 0.257。此外，双重感觉障碍与衰弱的交互效应显著预测了认知能力（效应值 = - 0.575，<0.001）。
本研究揭示了双重感觉障碍、焦虑、抑郁、认知表现和衰弱之间的作用机制。这一发现还意味着针对老年人心理问题、衰弱和感觉功能的治疗可以保留他们的认知能力。
