Longitudinal Associations of Self-Reported Visual, Hearing, and Dual Sensory Difficulties With Symptoms of Depression Among Older Adults in the United States

Abstract

Evidence conflicts on the association between sensory difficulty and depression. Few studies have examined this association using longitudinal or population-based data. We used data from Rounds 1–9 of the nationally representative National Health and Aging Trends Study to evaluate the longitudinal association between self-reported visual, hearing, and dual sensory difficulties and clinically significant depressive symptoms. Multivariable Cox regression models were used to evaluate the hazard of incident depressive symptoms. Group-based trajectory modeling identified depressive symptom trajectories (DSTs). Multinomial logistic regression was used to examine the association between sensory status and DSTs. A total of 7,593 participants were included: 56.5% were female, 53.0% were 65–74 years old, 19.0% (95% CI 17.9–20.2%) had hearing, 5.6% (4.9–6.4%) had visual, and 3.3% (2.9–3.8%) had dual sensory difficulties at baseline. Hazard ratios for depressive symptoms in those with visual, hearing, and dual sensory difficulties were 1.25 (95% CI 1.00–1.56, p = 0.047), 0.98 (95% CI 0.82–1.18, p = 0.82), and 1.67 (95% CI 1.29–2.16, p < 0.001), respectively, relative to those without sensory difficulty. A model with four trajectory groups best fit the data. Group 1 (35.8% of the sample, 95% CI: 34.1–37.4) had persistently low risk of depressive symptoms; Group 2 (44.8%, 43.4–46.3) had low but increasing risk; Group 3 (7.1%, 6.2–8.3) had moderate risk; and Group 4 (12.4%, 11.5–13.3) had moderate to high risk that increased. Compared to those without sensory difficulties, individuals with each difficulty were significantly more likely to belong to a group other than Group 1. This study reveals associations between sensory difficulties and mental health that can inform public health interventions.

Population Prevalence of Vision Impairment in US Adults 71 Years and Older

“…Characteristics of the individuals who were included in and excluded from the analytic sample are presented in eTable 1 in Supplement 1. Weighted sample characteristics are included in 6.4%-10.6%] college degree; P < .001), and lower income (16.0% [95% CI, 13.2%-18.8%] 0 to <$21 000, 11.1% [95% CI, 8.6%-13.7%] $21 000 to <$40 000, 8.5% [95% CI, 6.2%-10.8%] $40 000 to <$75 000, and 7.5% [95% CI, 5.1%-9.8%] ≥$75 000; P < .001), but not race and ethnicity (16.5% [95% CI, 13.0%-20.0%] among Black non-Hispanic respondents, 12.0% [95% CI, 5.5%-18.5%] among Hispanic respondents, 9.6% [95% CI, 8.1%-11.5%] among White non-Hispanic respondents, and 13.2% [95% CI, 3.5%-22.8%] among other non-Hispanic respondents; P = .10) or sex (10.3% [95% CI, 8.2%-12.4%] among male respondents and 10.2% [95% CI, 8.2%-12.3%] among female respondents; P = .95).…”

“…1 Because NHATS contains data on adults who transitioned to institutional settings since their baseline interview, oversamples ages 85 years and older, and is focused on the health of older adults, it is a rich source of data to study these groups that are at high risk of VI and for whom there are few existing data. Understanding the epidemiology of VI and blindness in this population is critical because adults 85 years and older are the fastest growing age group in the United States 5 and may also be at high risk for such downstream sequelae of VI as injurious falls, 25 depression, 6 cognitive decline, 26 and early mortality. 9 We found that the prevalence of all 3 measures of VI increased sharply among individuals 85 years and older, among whom the prevalence of distance VI and contrast sensitivity impairment were more than 20% and near VI was greater than 37%.…”

“…The number of people with VI and blindness in the United States is projected to double from 2015 to 2050, primarily from growth of the older population . Poor vision is associated with numerous adverse outcomes in later life, including depression, dementia, motor vehicle crashes, and even mortality . In 2017, the costs of caring for older adults with VI and blindness in the United States was $134.2 billion …”

Self‐rated eyesight among healthy older Australians: Baseline results of the ASPREE Longitudinal Study of Older Persons

“…However, these estimates have ranged from 9% in the United States to over 23% in Nigeria and in China. [7][8][9] In the mid-1990s, it was estimated that 8.3% of Victorians aged 65 years and above had bilateral visual impairment as determined by presenting visual acuity (<6/12) and/or reduced visual field. 1 One third of these cases were attributable to uncorrected refractive error.…”

Mental health support across the sight loss pathway: a qualitative exploration of eye care patients, optometrists, and ECLOs

“…The presence of an eye condition, becoming sight impaired, or severely sight impaired is undoubtedly a highly emotional experience [3]. For example, visual impairment has been independently associated with several mental health conditions, including depression [4][5][6][7], anxiety [5,6,8], and posttraumatic stress disorder [9]. Several studies report that eye care patients experience degrees of emotional trauma and may require some form of mental health support [10,11] which should not be limited to patients with recent diagnoses of an eye condition [10,12,13].…”