What Explains the Link Between Hearing and Vision Impairment and Cognitive Function? Analysis of Mediating Effects in the USA, England and Ireland

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry Pub Date : 2024-09-17 DOI:10.1002/gps.6149

Katey Matthews, Piers Dawes, Rebecca Elliot, Asri Maharani, Neil Pendleton, Gindo Tampubolon

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引用次数: 0

Abstract

Objectives

Hearing and vision impairments are associated with cognitive decline and dementia risk. Explanations for this include age-related processes impacting on sensory and cognitive function (common cause), or sensory impairments having a direct or indirect impact on cognition via social engagement, depression and physical activity (cascade). We tested whether associations between hearing, vision and episodic memory were mediated by allostatic load, social engagement, depression and physical activity.

Methods

We used structural equation modelling with cross-sectional data from the USA (n = 4746, aged 50–101), England (n = 4907, aged 50–89) and Ireland (4292, aged 50–80) to model factors related to the common cause (indexed by allostatic load) and the cascade hypothesis with respect to cognitive ability (episodic memory).

Results

Poorer hearing/vision was associated with lower social engagement, depression and sedentary lifestyle. Poor vision was not related to allostatic load, and poor hearing was associated with allostatic load in only one data set, contributing to a common-cause hypothesis. Lower social engagement, depression and a sedentary lifestyle were associated with poorer episodic memory, contributing to the cascade hypothesis. Using effect estimates to calculate the proportion of the total effects mediated by the combined mediator variables, up to two fifths of the relationship between hearing and vision with episodic memory can be explained by the mediators.

Conclusions

The association between hearing, vision and episodic memory is mediated by allostatic load, social engagement, depression, and physical activity. The finding that social engagement, depression, and physical activity mediate the association between sensory abilities and cognitive function supported the cascade hypotheses. Interventions to improve healthy lifestyle, reduce depression and foster social engagement of older people with sensory impairments are likely to be beneficial in preventing cognitive decline and dementia.

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如何解释听力和视力障碍与认知功能之间的联系？美国、英国和爱尔兰的中介效应分析

目标听力和视力障碍与认知能力下降和痴呆症风险有关。其原因包括与年龄有关的过程对感官和认知功能的影响（共同原因），或感官损伤通过社会参与、抑郁和体育锻炼对认知产生直接或间接的影响（连带影响）。我们测试了听力、视力和外显记忆之间的联系是否受异质负荷、社会参与、抑郁和体育锻炼的影响。方法我们利用来自美国（n = 4746，50-101 岁）、英国（n = 4907，50-89 岁）和爱尔兰（4292，50-80 岁）的横截面数据建立了结构方程模型，以模拟与认知能力（外显记忆）相关的共同原因（以异动负荷为指标）和级联假说的相关因素。结果听力/视力较差与较低的社会参与度、抑郁和久坐不动的生活方式有关。视力不佳与代谢负荷无关，而听力不佳仅在一个数据集中与代谢负荷相关，从而提出了共同原因假说。较低的社会参与度、抑郁和久坐不动的生活方式与较差的外显记忆有关，从而提出了连锁假说。利用效应估计值来计算综合中介变量在总效应中所占的比例，多达五分之二的听力和视力与外显记忆之间的关系可以用中介变量来解释。结论听力、视力和外显记忆之间的关系受异应激负荷、社会参与、抑郁和体育锻炼的影响。社会参与、抑郁和体育锻炼是感官能力与认知功能之间关系的中介，这一发现支持了级联假说。为改善有感官障碍的老年人的健康生活方式、减少抑郁和促进其社会参与而采取的干预措施很可能有益于预防认知能力下降和痴呆症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

6.10

自引率

2.50%

发文量

168

审稿时长

4-8 weeks

期刊介绍： The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers. The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.