Abstract：
OBJECTIVE: 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.
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.
摘要：
目的：感觉障碍是认知功能下降的一个假设危险因素；然而，社会心理途径还没有得到很好的理解。我们评估了视觉障碍（VI）和认知下降之间的关联是否部分通过抑郁症状介导，孤独,或社交活动。
方法：我们使用了1997年参加记忆和衰老项目的2601名老年人的数据，2004年参加了少数民族衰老研究，在长达16年的时间里，对5个领域进行了神经心理学测试。用Rosenbaum口袋视觉筛选器评估VI。抑郁症状,孤独,和社会活动使用经过验证的量表进行自我报告。我们使用结构方程模型来估计VI与基线和认知功能变化的关联，直接和间接地通过每个介体(抑郁症状，孤独,和社会活动)。我们使用结合抑郁症状和孤独感的潜在变量通过“心理困扰”评估调解。
结果：VI与全球认知能力下降之间的关联是通过较低的社会活动（间接效应）[95％置信区间（CI）]的线性斜率：-0.025（-0.048，-0.011），通过孤独感(-0.011[95%CI：-0.028，-0.002])，并通过心理困扰（-0.017[95%CI：-0.042，-0.003]）。我们没有找到足够的证据证明仅通过抑郁症状进行调解。
结论：VI对认知下降的有害影响可能部分是通过孤独感和较低的社交活动介导的。
方法：我们使用了1997年参加记忆和衰老项目的2601名老年人的数据，2004年参加了少数民族衰老研究，在长达16年的时间里，对5个领域进行了神经心理学测试。用Rosenbaum口袋视觉筛选器评估VI。抑郁症状,孤独,和社会活动使用经过验证的量表进行自我报告。我们使用结构方程模型来估计VI与基线和认知功能变化的关联，直接和间接地通过每个介体(抑郁症状，孤独,和社会活动)。我们使用结合抑郁症状和孤独感的潜在变量通过“心理困扰”评估调解。
结果：VI与全球认知能力下降之间的关联是通过较低的社会活动（间接效应）[95％置信区间（CI）]的线性斜率：-0.025（-0.048，-0.011），通过孤独感(-0.011[95%CI：-0.028，-0.002])，并通过心理困扰（-0.017[95%CI：-0.042，-0.003]）。我们没有找到足够的证据证明仅通过抑郁症状进行调解。
结论：VI对认知下降的有害影响可能部分是通过孤独感和较低的社交活动介导的。
