The Association of Late-Life Self-Reported Vision and Hearing Impairments with Cognitive Function: A 3-Year Longitudinal Mediation Analysis Through Social Isolation

Background and Objectives: Vision impairment (VI), hearing impairment (HI), and dual sensory impairment (DSI), are prevalent among older adults and have been associated with cognitive impairment in later life. Knowledge about mediating pathways that account for the association between sensory impairment and cognitive impairment is scarce. Mediators of this association could serve as possible future intervention targets. We examined longitudinal associations between sensory impairment and cognitive functioning indirectly through social isolation. Research Design and Methods: Data were taken from a nationally representative panel study, The National Health and Aging Trends Study, an annual survey of Medicare beneficiaries age ≥ 65. Participants (N = 6,286) from Rounds 5, 6, and 7 (2015, 2016, 2017), with complete data on self-reported VI and/or HI status at baseline. Structural equation models were estimated to test longitudinal direct and indirect associations. Results: Adjusting for covariates, cross-sectional results indicated that all sensory impairments (VI, HI, and DSI) were negatively associated with all cognitive functioning measures through social isolation. Longitudinally, only VI was indirectly associated with word-recall scores across 1 and 2 years through social isolation, as well as across 2 years for orientation. Discussion and Implications: As social isolation is both a consequence of sensory impairment and a risk factor for cognitive impairment, it provided a starting point from which to study the process of cognitive decline among those with sensory impairments. Awareness of the association of sensory impairment with social isolation, as well as its longitudinal implications for cognitive health, may enhance our ability to intervene.