Depression, loneliness, and lower social activity as partial mediators of the association between visual impairment and cognitive decline
Year: 2024
Type: article
Abstract: OBJECTIVES: Sensory impairment is a hypothesized risk factor for cognitive decline; however, the psychosocial pathways are not well understood. We evaluated whether the association between visual impairment (VI) and cognitive decline was partially mediated via depressive symptoms, loneliness, or social activity. METHODS: We used data from 2601 older adults enrolled in the Memory and Aging Project in 1997 and the Minority Aging Research Study in 2004 with neuropsychological tests across five domains measured annually for up to 16 years. VI was assessed with the Rosenbaum Pocket Vision Screener. Depressive symptoms, loneliness, and social activity were self-reported using validated scales. We used structural equation models to estimate the associations of VI with baseline and change in cognitive function, directly and indirectly through each mediator (depressive symptoms, loneliness, and social activity). We evaluated mediation via "psychological distress" using a latent variable combining depressive symptoms and loneliness. RESULTS: The association between VI and global cognitive decline was mediated via lower social activity (indirect effect) [95% confidence interval (CI)] of linear slope: -0.025 (-0.048, -0.011), via loneliness (-0.011 [95% CI: -0.028, -0.002]), and via psychological distress (-0.017 [95% CI: -0.042, -0.003]). We did not find sufficient evidence for mediation via depressive symptoms alone. CONCLUSIONS: The harmful effect of VI on cognitive decline may be partially mediated through loneliness and lower social activity.
DOI: 10.1002/gps.6123
Institutions: Johns Hopkins University, University of Michigan, Institute for Social Research, Temple University, Columbia University, Boston University, Leibniz Institute for Prevention Research and Epidemiology - BIPS, University of California, San Francisco, University of California, Riverside, Brown University
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Awards: Conference on Advanced Psychometric Methods in Cognitive Aging Research, Institutional Career Development Core, Air pollution and noise exposures in relation to dementia: from brain imaging markers to clinical disease, Preclinical markers of Alzheimer's disease using psycholinguistic semantic measures, Michigan Institute for Clinical and Health Research (MICHR), The role of toxic and essential metal mixtures, and co-exposures to social stressors, in cognitive aging, mild cognitive impairment, and novel epigenetic age biomarkers: The Baltimore Memory Study, Boston University Alzheimer's Disease Research Center, The role of toxic and essential metal mixtures, and co-exposures to social stressors, in cognitive aging, mild cognitive impairment, and novel epigenetic age biomarkers: The Baltimore Memory Study, Risk and resilience mechanisms underlying race disparities in ADRD: An examination of neighborhood resources, social networks, brain integrity, and cognition, MI Center for Contextual Factors in Alzheimer's Disease (MCCFAD) Yrs 6-10, Mechanisms of inequalities in ADRD risk across race and place in the Michigan Cognitive Aging Project
OpenAlex ID: W4400798374