Ji Xi, Zhang Yujie
School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, Xuhui District, China.
School of Public Policy and Administration, Chongqing University, Chongqing, Shapingba District, China.
PLoS One. 2025 Jul 9;20(7):e0328053. doi: 10.1371/journal.pone.0328053. eCollection 2025.
Vision impairment, beyond constituting a sensory deficit, fundamentally disrupts older adults' autonomy, emotional regulation, and social participation. These disruptions increase vulnerability to depressive symptoms. While the adverse mental health consequences of sensory decline are well-documented, the psychological mechanisms underlying this association remain insufficiently examined. Dispositional optimism-a stable cognitive-affective trait characterized by generalized positive future expectations-may serve as a key mediator, promoting resilience through adaptive appraisal and emotional regulation processes.
This study examines the mediating role of dispositional optimism in the relationship between vision impairment and depressive symptoms among older adults, and explores how its buffering effects vary by perceived control and socioeconomic resources. The findings aim to inform the integration of psychological resilience frameworks into geriatric mental health care and vision rehabilitation programs.
This study used panel data from 7,205 older adults in the 2014 and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Depressive symptoms were assessed using a harmonized CES-D scale, vision impairment through a field-based functional vision screening, and dispositional optimism via a 5-point Likert item. Ordered logit regression and bootstrapped mediation models were employed to estimate both direct and indirect effects, with subgroup analyses conducted to test for moderation by perceived control and socioeconomic status.
Vision impairment was significantly associated with increased depressive symptoms (β = -0.218, p < 0.001). Dispositional optimism mediated 24.7% of this effect (indirect effect = -0.004, p < 0.01), indicating its role as a psychological buffer. The protective function of optimism was more pronounced among individuals with higher perceived control (β = -0.135, p < 0.05), higher educational attainment (β = 0.264, p < 0.001), and better economic status (β = 0.210, p < 0.001). Notably, even among individuals with low perceived control, optimism continued to significantly mitigate depressive symptoms (indirect effect = -0.002, p < 0.05).
These findings reveal the importance of incorporating psychological resources into vision care strategies for older adults-particularly the oldest-old and those in socioeconomically disadvantaged contexts. Interventions aimed at fostering dispositional optimism, such as cognitive-behavioral techniques, may enhance emotional resilience, reduce depression risk, and improve quality of life in aging populations experiencing sensory decline.
视力障碍不仅是一种感觉缺陷，还会从根本上破坏老年人的自主性、情绪调节能力和社会参与度。这些破坏会增加患抑郁症状的易感性。虽然感觉衰退对心理健康的不良影响已有充分记录，但这种关联背后的心理机制仍未得到充分研究。特质乐观主义——一种以普遍积极的未来期望为特征的稳定认知情感特质——可能是一个关键的中介因素，通过适应性评估和情绪调节过程促进心理韧性。
本研究考察特质乐观主义在老年人视力障碍与抑郁症状关系中的中介作用，并探讨其缓冲效应如何因感知控制和社会经济资源的不同而变化。研究结果旨在为将心理韧性框架纳入老年心理健康护理和视力康复项目提供参考。
本研究使用了中国健康与养老追踪调查（CLHLS）2014年和2018年两轮调查中7205名老年人的面板数据。使用统一的CES-D量表评估抑郁症状，通过基于实地的功能性视力筛查评估视力障碍，通过一个5点李克特量表评估特质乐观主义。采用有序逻辑回归和自抽样中介模型来估计直接和间接效应，并进行亚组分析以检验感知控制和社会经济地位的调节作用。
视力障碍与抑郁症状增加显著相关（β = -0.218，p < 0.001）。特质乐观主义介导了这一效应的24.7%（间接效应 = -0.004，p < 0.01），表明其作为心理缓冲器的作用。乐观主义的保护作用在感知控制较高（β = -0.135，p < 0.05）、教育程度较高（β = 0.264，p < 0.001）和经济状况较好（β = 0.210，p < 0.001）的个体中更为明显。值得注意的是，即使在感知控制较低的个体中，乐观主义也继续显著减轻抑郁症状（间接效应 = -0.002，p < 0.05）。
这些发现揭示了将心理资源纳入老年人视力护理策略的重要性——尤其是年龄最大的老年人和社会经济处境不利的老年人。旨在培养特质乐观主义的干预措施，如认知行为技术，可能会增强情绪韧性，降低抑郁风险，并改善经历感觉衰退的老年人群的生活质量。
