Longitudinal Associations of Sensory and Cognitive Functioning: A Structural Equation Modeling Approach.

Abstract

Although visual and hearing impairments have been found to be associated with cognitive decline in the old age, the mechanism underlying this relationship remains unclear. This study aimed at assessing the predictive role of visual and hearing difficulties on subsequent cognitive functioning. From the cohort of the first (2002) and fifth waves (2010) of the English Longitudinal Study of Ageing (ELSA), 3,508 individuals aged 60 and older were included in the study. Five self-reported visual and hearing functioning items were used to assess sensory functioning at baseline. Cognition was assessed 8 years later by means of four measured tests covering immediate and delayed recall, verbal fluency, and processing speed. A Multiple Indicators Multiple Causes approach was used to assess the longitudinal associations of visual and hearing functioning with cognitive difficulties. A multigroup longitudinal measurement invariance was used to estimate latent change in cognitive difficulties across groups of participants presenting either visual, hearing, or dual sensory impairment (i.e., those reporting difficulties in both visual and hearing functioning items). Visual (β = 0.140, p < .001) and hearing (β = 0.115, p < .001) difficulties predicted cognitive difficulties 8 years later. The latent increase in cognitive difficulties was steeper in people with visual impairment (d = 0.52, p < .001), hearing impairment (d = 0.50, p < .001), and dual-sensory impairment (d = 0.68, p < .001) than those non-impaired (d = 0.12, p < .001). Visual and hearing difficulties were identified as predictors of subsequent cognitive decline in the old age. Interventions to prevent visual and hearing difficulties may have a substantial impact to slow down subsequent age-related cognitive decline.