Dual Sensory Impairment and Depressive Symptoms: Association and Pathways in Three Cohorts and a Meta-Analysis

IF 2.7 2区医学 Q1 PSYCHIATRY

Depression and Anxiety Pub Date : 2026-09-29 DOI:10.1155/da/8488263

Ping Ni, Li Liu, Li Zeng, Meiling Ge, Fang Wang, Xiuying Hu

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Abstract

Background

The overall impact of dual sensory impairment (DSI) on depressive symptoms and its underlying mechanisms remains unclear, particularly across different culture contexts. This study aimed to examine the association between DSI and depressive symptoms in three distinct populations while exploring the mediating roles of social engagement and cognitive function.

Methods

Participants were recruited from three aging cohorts: the China Health and Retirement Longitudinal Study (CHARLS), the Health and Retirement Study (HRS), and the English Longitudinal Study of Ageing (ELSA). Harmonized survey wave data (2011/2012, 2015/2016, and 2018) were analyzed. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D), and DSI was defined based on self-reported hearing and vision impairments. To address potential confounding, logistic regression models were adjusted for demographic, lifestyle, and health factors. Mediation analyses were conducted using the PROCESS Macro (model 4) to examine the roles of social engagement and cognitive function. Furthermore, a meta-analysis was performed by integrating the results of the present study with those from previous cohort studies.

Results

The study included 19,310 participants from the three cohorts. Separate analyses showed that DSI was significantly associated with higher odds of depressive symptoms across these cohorts (odds ratio [OR] = 1.24, 95% confidence interval [CI] = 1.15–1.33 in CHARLS; OR = 2.04, 95% CI = 1.78–2.31 in HRS; OR = 2.40, 95% CI = 1.79–3.00 in ELSA). A meta-analysis confirmed this association (OR = 1.73 and HR = 1.30). This relationship was partially mediated by reduced social engagement (2.31%–6.35%) and cognitive decline (5.72%–14.00%).

Conclusions

DSI is consistently associated with depressive symptoms in middle-aged and older adults across China, the United States, and England. Both reduced social engagement and cognitive decline significantly mediated this association, with comparable effect sizes. The mediation effects are largely robust, with instability observed only in one sensitivity analysis.

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查看原文本刊更多论文

双重感觉障碍和抑郁症状：三个队列和一项荟萃分析的关联和途径

背景：双重感觉障碍（DSI）对抑郁症状的总体影响及其潜在机制尚不清楚，特别是在不同的文化背景下。本研究旨在探讨三个不同人群的抑郁症状与DSI之间的关系，同时探索社会参与和认知功能的中介作用。方法：参与者从三个老龄化队列中招募：中国健康与退休纵向研究（CHARLS）、健康与退休研究（HRS）和英国老龄化纵向研究（ELSA）。对2011/2012年、2015/2016年和2018年协调调查波数据进行分析。使用流行病学研究中心抑郁量表（CES-D）评估抑郁症状，并根据自我报告的听力和视力障碍来定义DSI。为了解决潜在的混淆，对逻辑回归模型进行了人口统计、生活方式和健康因素的调整。使用PROCESS Macro（模型4）进行中介分析，检验社会参与和认知功能的作用。此外，将本研究的结果与以往的队列研究结果进行了荟萃分析。结果：该研究包括来自三个队列的19310名参与者。独立分析显示，在这些队列中，DSI与较高的抑郁症状发生率显著相关（CHARLS的比值比[OR] = 1.24, 95%可信区间[CI] = 1.15-1.33； HRS的比值比[OR] = 2.04, 95% CI = 1.78-2.31； ELSA的比值比[OR] = 2.40, 95% CI = 1.79-3.00）。荟萃分析证实了这一关联（OR = 1.73, HR = 1.30）。社会参与减少（2.31% ~ 6.35%）和认知能力下降（5.72% ~ 14.00%）在其中起部分中介作用。结论：在中国、美国和英国的中老年人群中，DSI始终与抑郁症状相关。社会参与减少和认知能力下降都显著调节了这种关联，效果大小相当。中介效应在很大程度上是稳健的，只有在一个敏感性分析中观察到不稳定性。

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

Depression and Anxiety 医学-精神病学

CiteScore

15.00

自引率

1.40%

发文量

审稿时长

4-8 weeks

期刊介绍： Depression and Anxiety is a scientific journal that focuses on the study of mood and anxiety disorders, as well as related phenomena in humans. The journal is dedicated to publishing high-quality research and review articles that contribute to the understanding and treatment of these conditions. The journal places a particular emphasis on articles that contribute to the clinical evaluation and care of individuals affected by mood and anxiety disorders. It prioritizes the publication of treatment-related research and review papers, as well as those that present novel findings that can directly impact clinical practice. The journal's goal is to advance the field by disseminating knowledge that can lead to better diagnosis, treatment, and management of these disorders, ultimately improving the quality of life for those who suffer from them.