Objectives Sensory impairments are prevalent among older adults and have been associated with cognitive challenges in later life, yet mechanisms are less well understood. We examined the mediating role of social isolation in the longitudinal relationship between self-reported sensory difficulty and impaired cognitive functioning among older adults. Methods Data were taken from the NHATS Study, an annual survey of Medicare beneficiaries’ age ≥ 65. Participants ( N = 6,338) provided data at Rounds 5, 6, and 7 (2015, 2016, 2017). Structural equation models were estimated to test longitudinal direct and indirect associations. Results All sensory difficulties were negatively associated with all cognitive functioning measures cross-sectionally through social isolation. Longitudinally, vision difficulty and dual sensory difficulty were indirectly associated with cognitive functioning across time. Hearing difficulty had no longitudinal indirect associations with cognitive functioning through social isolation. Discussion Social isolation is an important pathway through which late-life vision difficulty is associated with decreased cognitive function.

Objectives Sensory disabilities, including vision disability and hearing disability, increase risk for social isolation, which is associated with multiple negative health outcomes. Existing literature suggests that the cultural value of familism may provide a buffer against social isolation. We examined the longitudinal trajectory of social isolation among Hispanic older adults with self-reported vision disability (SRVD) and self-reported hearing disability (SRHD) and tested a modified measure of social isolation incorporating familism. Methods We compared 8-year trajectories of social isolation among Hispanics (n = 445) and non-Hispanic Whites (n = 4,861) from the National Health and Aging Trends Study. We used structural equation modeling to explore the longitudinal relationships between sensory disability and social isolation while comparing two measures of social isolation. Results Social isolation increased longitudinally for both groups, with SRVD significantly associated with higher initial levels. Social isolation started and remained higher across time among Hispanics. Using an adjusted measure of social isolation (added familial support), neither initial levels nor trajectories of social isolation differed between Hispanic and non-Hispanic White participants. Discussion Initially, Hispanics appeared more socially isolated, reporting less social support from outside the home. Yet, we found that they were more likely to report family social connections. Traditional measures of social isolation focusing on social support outside of the home (neglecting support by family) may lack content validity among Hispanic groups. Culturally sensitive measures of social isolation will be increasingly consequential for future research and health policy to meet the needs of a diverse older population.

Although the likelihood of developing a disability increases with age among all demographics, older adults of hispanic origin are more likely to experience vision and hearing impairment than both their white and black non-hispanic counterparts. Both hearing impairment and vision impairment are known risk factors for social isolation, yet little research has examined this association in Hispanic populations. Using data from 472 Hispanic and 5,186 White participants of the NHATS study, we examined 8-year trajectories of social isolation, along with how sensory impairment was associated with initial levels and change over time. Findings suggest that sensory impairments are linked with steeper increases over time among White participants. Among Hispanics vision and hearing impairments were linked with higher initial levels of social isolation, yet no associations were found across time. It may be that Hispanic older adults maintain social connections across time despite potentially isolating sensory impairments.

Hearing and vision loss have been linked with cognitive decline in older adults. There may be various pathways through which sensory impairments impact cognitive functioning. Sensory impairments may lead individuals to be less socially connected, which may impact cognitive functioning due to less cognitive stimulation. As such, sensory impairments and social isolation may cascade to negatively impact cognitive functioning. Using data from 8,334 individuals aged 65-90+ in waves 6, 7, and 8 of the NHATS study, we estimated a longitudinal mediation structural equation model. Findings indicate that both self-reported vision and hearing impairment in wave 6 of NHATS were linked to concurrent cognitive functioning through social isolation. Only hearing impairment demonstrated longitudinal impact through social isolation across 2 and 3 waves. Findings suggest that medical professionals working with older adults with vision or hearing impairment should assess social isolation, as a point of intervention to maintain cognitive function.

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