Relationship between Vision Impairment and Loneliness in Older Chinese: The Mediating Role of Depression

DOI: https://doi.org/10.62517/jmpe.202618115

Author(s)

Yi Zhang, Jingying Wang*

Affiliation(s)

Medical Technology Department, Chongqing Medical and Pharmaceutical College, Chongqing, China *Corresponding Author

Abstract

While vision impairment is a known risk factor for adverse psychosocial outcomes, its specific links to social isolation and loneliness, along with the underlying mediating mechanisms, remain under explored in aging Chinese. This study aimed to investigate these associations and examine potential mediators. We utilized data from the China Health and Retirement Longitudinal Study (CHARLS), following a cohort of adults aged 45 years or older from 2011 (wave 1) to 2015 (wave 3). Participants with incomplete data on demographics, vision, social relationships, or depression, or with baseline loneliness or social isolation, were excluded. Associations were assessed using Cox regression, and mediation analysis was employed to quantify the mediating effect. The analytic sample consisted of 3,379 Chinese adults (mean age, 59.26±8.29 years; 50.3% male). Longitudinally, distance vision impairment was associated with a significantly increased risk of incident loneliness (HR = 1.218, 95% CI: 1.028–1.442) rather than social isolation. Mediation analysis confirmed that depression accounted for 17.7% of this association (P = 0.006). Distance vision impairment was independently linked to increased loneliness, which was mediated by depression. The findings implied that implementing actively targeted interventions in preventing loneliness among aging Chinese people should focus on distance vision impairment and depression.

Keywords

Distance Vision Impairment; Loneliness; Social Isolation; Depression; Aging People

References

[1]Blindness and vision impairment. 10 August 2023; Available from: https://www.who.int/news-room/fact-sheets/detail/blindness-and-visual-impairment. [2]Huang, A.R., et al., Hearing and vision impairment and social isolation over 8 years in community-dwelling older adults. BMC Public Health, 2024. 24(1): p. 779. [3]Teo, R.H., et al., Global prevalence of social isolation among community-dwelling older adults: A systematic review and meta-analysis. Archives of Gerontology and Geriatrics, 2023. 107: p. 104904. [4]Surkalim, D.L., et al., The prevalence of loneliness across 113 countries: systematic review and meta-analysis. Bmj, 2022. [5]He, J., et al., Associations Between Vision and Hearing Impairment and Cardiovascular Diseases: A Longitudinal Cohort of Middle‐Aged and Older Adults in China. Journal of the American Heart Association, 2024. [6]Lin, L., et al., Association of Adverse Childhood Experiences and Social Isolation With Later-Life Cognitive Function Among Adults in China. JAMA Netw Open, 2022. 5(11): p. e2241714. [7]Song, Y., et al., Social isolation, loneliness, and incident type 2 diabetes mellitus: results from two large prospective cohorts in Europe and East Asia and Mendelian randomization. eClinicalMedicine, 2023. 64. [8]Guo, L., et al., Social isolation, loneliness and functional disability in Chinese older women and men: a longitudinal study. Age Ageing, 2021. 50(4): p. 1222-1228. [9]Xian, G., et al., The relationship between healthy lifestyles and cognitive function in Chinese older adults: the mediating effect of depressive symptoms. BMC Geriatr, 2024. 24(1): p. 299. [10]Almidani, L., et al., Vision Impairment and Psychosocial Function in US Adults. JAMA Ophthalmol, 2024. 142(4): p. 283-291. [11]Yang, Y., et al., Associations of self-reported vision impairment with depression symptoms among middle-aged and older Chinese. Aging Clinical and Experimental Research, 2022. 34(9): p. 2117-2128. [12]Brush, C.J., et al., The P300, loneliness, and depression in older adults. Biological Psychology, 2022. 171. [13]Domènech-Abella, J., et al., Loneliness and depression in the elderly: the role of social network. Social Psychiatry and Psychiatric Epidemiology, 2017. 52(4): p. 381-390.