Understanding the Multi-Dimensional Impact of Health Difficulties in an Ageing Population: A Literature Review

The ageing U.S. population, as highlighted in The Data Corner’s 2024 metrics presents a pressing challenge for healthcare agencies and policymakers aiming to enhance living conditions. Addressing this issue necessitates a deep dive into current research to understand the multifaceted health difficulties this demographic faces.

This literature review centers on the impact of cognitive, independent living, self-care, ambulatory, and vision or hearing difficulties on health outcomes and quality of life. Focusing on few recent studies from the past five years (2019-2023), exploring how these health challenges contribute to depression, chronic anxiety, cognitive impairment, functional dependence, and an overall diminished quality of life. Particularly, research into the compound effects of dual sensory impairments reveals a complex interplay that exacerbates individual risks, drives social isolation, impairs cognitive function, and underscores the need for comprehensive care strategies. By synthesizing findings from a selection of pertinent studies, this review aims to shed light on the intricate relationship between various health-related difficulties and their broader impact on the lives of older adults.

1. Combined Vision and Hearing Difficulties Results in Higher Levels of Depression and Chronic Anxiety: This study emphasizes that individuals with dual sensory impairment (difficulty seeing and hearing) exhibit significantly higher odds for depression and chronic anxiety compared to those with either impairment alone, suggesting the need for targeted interventions (Pardhan et al., 2021).

2. Older Adults With a Combination of Vision and Hearing Impairment Experience Higher Rates of Cognitive Impairment and Functional Dependence: Research shows that older adults with dual sensory impairment (DSI) have higher rates of adverse events across many health-related outcomes, including cognitive decline and functional impairments (Davidson & Guthrie, 2019).

3. Self-Reported Dual Sensory Impairment and Subjective Cognitive Complaints: A study found that older Americans with DSI reported a threefold increased prevalence of subjective cognitive complaints, underlining the importance of addressing multiple impairments when studying subjective cognition in older adults (Smith et al., 2022).

4. The Longitudinal Association of Late-Life Visual and Hearing Difficulty and Cognitive Function: This research examined the mediating role of social isolation in the relationship between sensory difficulty and impaired cognitive functioning among older adults, finding that vision difficulty and dual sensory difficulty were indirectly associated with cognitive functioning through social isolation (Yorgason et al., 2022).

5. Combined effects of frailty status and cognitive impairment on health-related quality of life among community dwelling older adults: This study highlighted the strong association between co-occurring frailty/pre-frailty and cognitive impairment with self-reported health problems across all domains of health-related quality of life, emphasizing the prevalence and impact of these co-occurring conditions (Li et al., 2019).

6. Vision and Hearing Difficulties and life expectancy without ADL/IADL-limitations: An analysis found that either vision or hearing difficulty was associated with shorter life expectancy without ADL/IADL limitations, and dual sensory difficulty further reduced life expectancy, underlining the importance of reducing the prevalence and incidence of these difficulties to increase years lived without ADL/IADL-limitations (Zaninotto et al., 2023).

Conclusion: the intertwined challenges of health difficulties within an aging population necessitate a unified approach toward crafting innovative and lasting health strategies. This complexity calls for the development of strong healthcare policies and the implementation of flexible service delivery models designed to meet the evolving needs of our aging society. Looking ahead, the vital roles of continuous monitoring and dynamic policy adaptation cannot be emphasized enough. They are foundational to safeguarding the health and well-being of all Americans against the backdrop of shifting health landscapes and demographic transformations. Through collaborative efforts among healthcare professionals, policymakers, researchers, and communities, we can navigate these challenges and foster a healthier future for every individual. Together, informed and proactive steps today will pave the way for a society that thrives in health and vitality, regardless of age.

References:

Data: TheDC (2024), Gednder & Age, DC701/DC702. The Data Corner:
https://thedatacorner.com/variables/gender-age/

Pardhan, S., Smith, L., Bourne, R., Davis, A., Leveziel, N., Jacob, L., Koyanagi, A., & López-Sánchez, G. (2021). Combined Vision and Hearing Difficulties Results in Higher Levels of Depression and Chronic Anxiety: Data From a Large Sample of Spanish Adults. Frontiers in Psychology, 11. https://doi.org/10.3389/fpsyg.2020.627980

Davidson, J. G. S., & Guthrie, D. (2019). Older Adults With a Combination of Vision and Hearing Impairment Experience Higher Rates of Cognitive Impairment, Functional Dependence, and Worse Outcomes Across a Set of Quality Indicators. Journal of Aging and Health, 31, 108-85. https://doi.org/10.1177/0898264317723407

Smith, J. R., Betz, J., Garcia, E. E., Jiang, K., Swenor, B., Reed, N., & Deal, J. (2022). Self-Reported Dual Sensory Impairment and Subjective Cognitive Complaints Among Older Adults in the 2019 National Health Interview Survey. American Journal of Audiology. https://doi.org/10.1044/2022_AJA-22-00087

Yorgason, J., Tanner, C., Richardson, S., Hill, M., Stagg, B. C., Wettstein, M., & Ehrlich, J. R. (2022). The Longitudinal Association of Late-Life Visual and Hearing Difficulty and Cognitive Function: The Role of Social Isolation. Journal of Aging and Health, 34, 765-774. https://doi.org/10.1177/08982643211063338

Li, C.-L., Chang, H.-Y., & Stanaway, F. (2019). Combined Effects of Frailty Status and Cognitive Impairment on Health-Related Quality of Life Among Community Dwelling Older Adults. Archives of Gerontology and Geriatrics, 87, 103999. https://doi.org/10.1016/j.archger.2019.103999

Zaninotto, P., Maharani, A., & Di Gessa, G. (2023). Vision and Hearing Difficulties and Life Expectancy Without ADL/IADL-Limitations: Evidence from the English Longitudinal Study of Ageing and the Health and Retirement Study. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences. https://doi.org/10.1093/gerona/glad136