Associations of cumulative hearing and vision loss with depression among U.S. adults aged 50 and older: results from the health and retirement study

Abstract

Background

Hearing or vision loss at a single time point was associated with depression. However, little is known about how cumulative hearing and vision loss contributes to the depression risk. We aimed to examine associations of cumulative hearing loss (CHL), vision loss (CVL), dual sensory loss (CDSL), and any sensory loss (CASL) with the subsequent trajectories of depressive symptoms and risks of incident depression among US adults aged ≥ 50.

Methods

A subpopulation was extracted from the Health and Retirement Study (HRS), a nationally representative cohort study. The final sample included 7,545 adults aged 50 and older. Burdens of CHL, CVL, CDSL, and CASL were assessed spanning eight years (1998–2006) across five Waves (Waves 4–8) and were categorized into 0, 1, 2, and ≥ 3 time points. Depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale (CES-D) during a ten-year follow-up from Wave 9 (2008) to Wave 15 (2020). Mixed-effects linear regression models were used to estimate associations between CVL and changes in depressive symptoms over time (CES-D scores), incorporating CVL × time interactions to assess differential rates of change. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between CVL and the risk of incident depression. Models were adjusted for sociodemographic factors (Model 1) and additionally for lifestyle and health-related covariates (Model 2). Similarly, we separately analyzed associations of CHL, CBSL, and CASL with trajectories of depressive symptoms and risks of incident depression.

Results

Two thousand four hundred twenty-one participants developed an incident depression over a median follow-up of eight years. Results indicated that compared with participants without vision loss, those with CVL at 1, 2, and ≥ 3 time points during Waves 4–8 had significantly higher CES-D scores and higher risks of incident depression during Waves 9–15. Similar positive associations were found for CHL, CDSL, and CASL.

Conclusions

Heavier burdens of CHL, CVL, CDSL, and CASL were associated with accelerated increases in depressive symptoms and elevated risks of incident depression among US adults aged 50 and older.