Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: May 6, 2022
Date Accepted: Oct 18, 2022
Dual sensory impairment predicts loneliness but not social isolation in older adults: a national cohort study
ABSTRACT
Background:
Dual sensory impairment (DSI), loneliness and social isolation are all highly prevalent among older adults, but the relationship between DSI and loneliness and social isolation among Chinese older adults is not well understood.
Objective:
To analyze the effects of dual sensory impairment (DSI) on loneliness and social isolation among older adults in rural and urban China.
Methods:
This cohort study of 3,069 older adults (aged 60+) used data from four waves (2011, 2013, 2015, and 2018) of the China Health and Retirement Longitudinal Survey (CHARLS), a nationally representative survey of adults aged 45 years or older. DSI was defined as the the co-occurrence of vision impairment (VI) and hearing impairment (HI). Participants in the study with complete data on hearing, vision, social isolation and loneliness were included in analysis. Generalized estimating equation models adjusted for covariates were used to examine the relationships of DSI with loneliness and social isolation among older adults.
Results:
Compared to older adults without sensory impairment, those with DSI were at a higher risk of loneliness. In rural areas, DSI showed a statistically significant association with loneliness compared with HI only (OR=1.24, 95% CI: 1.17-1.31), VI only (OR=1.12, 95% CI: 1.08-1.17) and no SIs (OR=1.86, 95% CI: 1.57-2.19). In urban areas, participants with VI only (OR=2.38, 95% CI: 1.53-3.71), HI only (OR=2.43, 95% CI: 1.39-4.24) and DSI (OR=1.91, 95% CI: 1.26-2.90) were more likely to experience loneliness compared to participants without SIs. DSI was not associated with increased likelihood of loneliness compared with HI only or VI only. SIs was not associated with social isolation among older adults in urban and rural areas.
Conclusions:
This study demonstrates a compounded risk of DSI on loneliness exists in rural areas rather than in urban areas. Interventions targeting HI only and DSI might be particularly effective for mitigating loneliness of older adults in urban and rural areas respectively.
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