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.
Highlights
Sensory loss and depression are both leading causes of morbidity and can impact daily life (Mathers and Loncar, 2006)
This may be due to behavioral mechanisms such as withdrawal from social situations because of difficulties communicating or seeing and ensuing isolation and/or due to neural changes (Rutherford et al, 2018). Unlike those with single sensory loss, older adults with dual sensory loss may be at increased risk for depressive symptoms because they are unable to compensate for a single sensory loss with retained vision or hearing (Hovaldt et al, 2018)
We found that all sensory difficulties were associated with an increased risk of belonging to trajectory groups with a higher baseline risk and an increased risk over time of clinically significant depressive symptoms
Summary
Sensory loss and depression are both leading causes of morbidity and can impact daily life (Mathers and Loncar, 2006). Depressive symptoms are common in individuals with dual sensory loss (Lupsakko et al, 2002) This may be due to behavioral mechanisms such as withdrawal from social situations because of difficulties communicating or seeing and ensuing isolation and/or due to neural changes (Rutherford et al, 2018). There are no studies examining the association of hearing, visual, and dual sensory difficulty with depressive symptoms over a period of greater than 2 years in a nationally representative sample of older United States adults. Such data are vital to the development of public health programs and interventional studies that may seek to address this issue
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