Physical function mediates the effects of sensory impairment on quality of life in older adults: Cross-sectional study using propensity-score weighting.

AIMS: To investigate the effect of sensory impairment on quality of life in older adults and to assess the role of physical function as a mediator of the effect of the sensory impairment on quality of life. DESIGN: A cross-sectional study. METHODS: Older adults aged ≥65 years (N = 600) were recruited from January 2019 to May 2020. Hearing and visual function were measured with pure-tone audiometry and Snellen visual acuity tests, respectively. Quality of life (World Health Organization Quality of Life Scale Brief Version), physical function (Multidimensional Functional Assessment Questionnaire) and sociodemographic characteristics were reported by participants using interviewer-administered questionnaires. Propensity score weighting analysis was conducted based on generalized propensity scores via multinominal logistic regression for age, gender, education, income, and comorbidities. The difference in the quality of life was tested by applying a one-way analysis of variance. Multiple mediation analysis was conducted to explore the direct, indirect, and total effects of sensory impairment on quality of life through physical function. RESULTS: After propensity score weighting adjustment, when compared with participants with no sensory impairment, participants with dual sensory impairment had the worst quality of life, followed by visual impairment and then hearing impairment. Physical function statistically significantly mediated the effect of hearing impairment, visual impairment and dual sensory impairment on quality of life in older adults. CONCLUSION: Our findings demonstrated that the negative effect of the sensory impairment on quality of life in older adults was mediated through physical function. IMPACT: The convergence of an increasing ageing population and the prevalence of sensory impairment presents a significant global health burden. This study demonstrated that physical function was a mediator of quality of life in older adults. Designing appropriate physical activity interventions for older adults with sensory impairment could serve to enhance physio-psychological health and improve quality of life.

Validation of the Chinese version of the Life-Space Assessment in community-dwelling older adults.

The Life-Space Assessment (LSA) is a comprehensive tool for assessing mobility in older adults, but the evidence of its psychometric properties in Chinese older adults is lacking. The aim was to adapt and validate the psychometric properties of the Chinese version of the Life-Space Assessment (LSA-C) in community-dwelling older adults. A cross-sectional study was designed with 225 community-dwelling older adults. The content validity of the LSA-C was satisfactory. The criterion validity was supported by significant correlation between the LSA-C and the Multidimensional Functional Assessment Questionnaire (MFAQ). Additionally, the LSA-C was negatively correlated with the 10-item Center for Epidemiological Studies Depression Scale (CESD-10) and positively correlated with the General Health subscale of the Short-Form-36 Health Survey (GH of the SF-36), implying good construct validity. Finally, the LSA-C showed excellent stability (intraclass correlation coefficient = 0.88). The LSA-C demonstrates adequate psychometric properties, supporting its use in future research in the Chinese context.

Quality of life in older adults with sensory impairments: a systematic review.

PURPOSE: Sensory impairments are common in older adults. Hearing and visual impairments affect their physical and mental health and quality of life adversely. However, systematic reviews of the relationship between hearing impairment, visual impairment, dual sensory impairment, and quality of life are scarce. The purpose of this systematic review was to determine the relationship between hearing impairment, visual impairment, dual sensory impairment, and quality of life. METHODS: Searches of EMBASE, PubMed, CINAHL, MEDLINE, Cochrane Library, and Airiti Library were conducted between January 2006 and December 2017 using the keywords "quality of life," "life satisfaction," "well-being," "hearing impairment," and "visual impairment." Two authors independently assessed methodologic quality using a modified Downs and Black tool. Data were extracted by the first author and then cross-checked by the second author. RESULTS: Twenty-three studies consisting mostly of community-dwelling older adults were included in our review. Sensory impairment was found to be in significant association with quality of life, with an increase in hearing impairment or visual impairment severity resulting in a lower quality of life. Quality of life for dual sensory impairment was worse than for hearing impairment or visual impairment individually. CONCLUSIONS: A significant association was confirmed between hearing impairment, visual impairment, dual sensory impairment, and quality of life. Our review can be used to enhance health care personnel's understanding of sensory impairment in older adults and enable health care personnel to actively assess older adults' sensory functions, so that they can help alleviate the negative impact of sensory impairments on QOL in older adults.