The impact of hearing loss on cognitive impairment: The mediating role of depressive symptoms and the moderating role of social relationships

Xia Cao; Qian Liu; Jiali Liu; Bingfang Yang; Jiansong Zhou

doi:10.3389/fpubh.2023.1149769

The impact of hearing loss on cognitive impairment: The mediating role of depressive symptoms and the moderating role of social relationships

Front Public Health. 2023 Apr 4:11:1149769. doi: 10.3389/fpubh.2023.1149769. eCollection 2023.

Authors

Xia Cao¹, Qian Liu², Jiali Liu³, Bingfang Yang¹, Jiansong Zhou³

Affiliations

¹ Health Management Center, The Third Xiangya Hospital, Central South University, Changsha, China.
² Department of Psychology, Hunan Normal University, Changsha, China.
³ Department of Psychiatry and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China.

Abstract

Background: Given the potentially negative effects of hearing loss on mental health and cognitive function, it is critical to gain a better understanding of the mechanisms underlying the link between hearing loss and cognitive impairment. This study aimed to investigate the moderating effects of social relationships, including their components in the role of depressive symptoms as a mediator between hearing loss and cognitive impairment.

Methods: Cross-sectional analyses were conducted with 8,094 Chinese older adults (aged ≥65 years) from the Chinese Longitudinal Healthy Longevity Survey in 2018. Simple mediation analysis and moderated mediation analysis were conducted to examine the roles of depressive symptoms and social relationships in the association between hearing loss and cognitive impairment.

Results: There is a significant correlation between hearing loss, depressive symptoms, social relationships, and cognitive function. Depressive symptoms partially mediated the association between hearing loss and cognitive function [standardized regression B-coefficient (B) = -0.114; 95% confidence interval (CI): (-0.158, -0.076)]. Social relationships moderated the effect of hearing loss on cognitive function through both path b (depressive symptoms - cognitive function) [B = 0.021; 95% CI: (0.008, 0.034)], and path c' (hearing loss-cognitive function) [B = 0.597; 95% CI: (0.463, 0.730)]. Furthermore, social activities and social networks moderated both the direct and indirect effects of moderated mediation. However, there appeared to be no moderated effect of social support for both the direct and indirect paths.

Conclusion: Social relationships moderated both the direct and indirect effects of depressive symptoms on the association between hearing loss and cognitive impairment. These findings shed light on the mechanisms underlying the relationship between hearing loss and cognitive impairment in Chinese older adults. It might be worthwhile to recommend multidimensional health and social interventions aimed at improving mental health and social inclusion among older adults with hearing loss.

Keywords: cognitive impairment; depressive symptoms; hearing loss; older adults; social relationships.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cognitive Dysfunction*
Cross-Sectional Studies
Depression / psychology
Hearing Loss*
Humans
Interpersonal Relations