Sensory disability challenges mental health as we age

When we think of issues that might contribute to poor mental health in older adults, many of us will immediately think of loneliness and isolation. However, a new paper from the University of Chicago reminds us that, as is often the case, other factors can have a significant negative impact. With 94% of older adults in the US experiencing impairment in at least one sense, and 67% in two or more, this work demonstrates the need to better understand the impact that sensory disability can have on mental wellbeing in this population.

This research, published recently in the Journal of the American Geriatrics Society, explores how sensory disability specifically can have knock-on effects for older people's mental health. Here, the authors define sensory disability as impaired functionality in eyesight, hearing, smell, taste, or touch, and focus this study on the first three. Through their analyses, they find that greater numbers of sensory disabilities are associated with worse mental health — and that different kinds of disability have different impacts.

Data was gathered from a longitudinal study on ageing which started in 2005–2006 and continued until 2015–2016, and comprised data from 3940 participants aged between 57 and 85. For this study, two key factors were measured: sensory function and mental health.

Firstly, professional, trained interviewers rated each participant's hearing and vision on a scale from 1 to 5, 1 being "practically deaf/blind" and 5 being typical hearing or vision. Those with scores lower than 3 were classed as having a sensory disability. Those who were unable to identify more than three scents in a validated odour identification test involving five scented felt tips were considered to have an olfactory disability.

Information on participants' mental health was obtained both through self-rating (on a 5-point scale from 'poor' to 'excellent') and standardised tests measuring depression, stress, anxiety, and loneliness.

Analyses showed that the higher the number of sensory disabilities a participant had been identified as having, the higher the chance they would rate their mental health as poor and that they had symptoms of loneliness. Those with visual impairment had a significantly greater risk of low self-rated mental health and frequently feeling lonely. Though these analyses found no other significant relationships between hearing and olfactory disability and mental health, the authors note that hearing disability seemed to have strong links to self-rated mental health and loneliness, and olfactory disability with self-rated mental health and stress.

The team hypothesise that these links may be related to ableism and accessibility: while they argue that people with hearing and vision disability "experience greater difficulty finding accessible and accommodating mental health services," this is unlikely to be the full picture. Research from disability charities including Prevent Blindness have found a number of reasons that sensory loss might impact someone's mental health, including decreased independence, changes in sense of self, or grieving for the loss of an important part of their life. While ableism is, of course, a huge issue for disabled people, a broader understanding of the impact of sensory loss may be more useful for professionals engaging with disabled older people.

Understanding the interplay between sensory disability and mental health is crucial to providing well-rounded support for older adults. The team argues that healthcare professionals should factor in sensory loss when discussing mental health issues with older people, and vice versa. They also put forward to suggestion that specialists dealing with sight and hearing could also use this knowledge to screen for mental health conditions, start conversations with patients, and signpost to specific mental health support.  

Read the paper in full:
Wang, A. Z., Wroblewski, K. E., Hawkley, L., & Pinto, J. M. (2024). Types of sensory disability are differentially associated with mental health in older US adults over time. Journal of the American Geriatrics Society. https://doi.org/10.1111/jgs.19056

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