Prevalence of sensory impairments and associations with symptoms of anxiety and depression in US older adults

BACKGROUND: Sensory impairments are common in older adults and may contribute to mental health problems. However, nationally representative data on sensory impairments, especially objective measured impairments, and their associations with emotional symptoms remain limited. This study aims to evaluate the age-specific prevalence of sensory impairments and investigate their short-term prospective associations with depression and anxiety among older adults living in the United States. METHODS: Data were from the round 12 (2022) and 13 (2023) of the National Health and Aging Trends Study (NHATS), a nationally representative survey of Medicare beneficiaries ≥ 65 years in the United States. We included 5,020 participants with objective vision/hearing tests and mental health questionnaires. Age-specific prevalence of objective and self-reported sensory impairments was calculated. Cox proportional hazards regression models, accounting for the complex survey design, were used to evaluate the short-term prospective associations between sensory impairments and depression and anxiety symptoms, measured via Patient Health Questionnaire-4. RESULTS: Of the 5,020 participants (weighted: 54.8% female; 79.3% White), the prevalence of objectively measured vision impairment (VI), hearing impairment (HI), and dual sensory impairment (DSI) was 30.9%, 20.9%, and 8.6%, respectively. However, the self-reported prevalence was substantially lower, with only 7.1%, 16.8% and 1.5% reporting VI, HI and DSI, respectively. Longitudinal analyses included 4,453 participants without baseline depressive symptoms and 4,519 without baseline anxiety. Compared with those without impairments, objective VI alone (adjusted hazards ratio[aHR], 2.29; 95% CI, 1.41-3.72), HI alone (aHR, 2.14; 95% CI, 1.24-3.68) and DSI (aHR, 2.40; 95% CI, 1.17-4.93) were significantly associated with an increased risk of anxiety symptoms over a median follow-up of 10.1 months. No significant associations were observed for depressive symptoms. CONCLUSIONS: Objectively measured sensory impairments were highly prevalent among US older adults and were associated with an increased risk of anxiety, but not depressive symptoms over a short follow-up duration. Self-reports considerably underestimated true prevalence of mild- to- moderate impairment, emphasizing the need for routine objective assessment in clinical practice and research.