Publication Date

Spring 5-5-2026

Document Type

Student Project

First Advisor

Liu, Yujun

Degree Name

B.S. (Bachelor of Science)

Department

Department of Biological Sciences

Abstract

Introduction: Sensory impairment is one of the most prevalent chronic conditions in later life and has been consistently associated with poorer cognitive outcomes. While prior research has documented associations between sensory loss and global cognitive decline, less attention has been paid to the psychosocial mechanisms that may explain this relationship. Understanding these pathways is essential for identifying modifiable intervention targets. This scoping review mapped and synthesized the existing literature on associations between hearing and vision impairment and cognitive function in adults aged 60 years and older, with a specific focus on psychosocial mechanisms linking sensory function and cognition in later life.

Methods: Following PRISMA-ScR guidelines, we conducted a systematic search of peer-reviewed articles published between 2008 and 2026 in major electronic databases including PubMed/MEDLINE, Nursing and Allied Health Premium (ProQuest), PsycINFO (ProQuest), Scopus, and CINAHL Complete (EBSCO). Eligible studies included observational research examining hearing and vision impairment in relation to cognitive outcomes (global cognition, memory, executive function, processing speed) among community-dwelling older adults. Studies focusing solely on subjective self-rated vision or hearing at baseline were excluded. 1,670 articles were retrieved, 217 articles were screened following de-duplication, 29 articles were included for full-text review, 25 articles were included in the final review. Data were extracted on study characteristics, hearing, vision and cognitive measures, analytic approaches, and psychosocial mechanisms assessed (e.g., depressive symptoms, social isolation, social engagement, physical activity, cognitive stimulation). Findings were synthesized descriptively and organized thematically.

Results: The final sample represented diverse geographic regions and study designs, including both cross-sectional and longitudinal cohorts. Across studies, objective vision impairment, particularly reduced visual acuity and contrast sensitivity, was consistently associated with lower global cognitive performance and poorer executive function. Longitudinal evidence suggested that baseline hearing and visual impairment predicted accelerated cognitive decline over time. Five interrelated thematic domains emerged: (1) social disconnection and relational processes, (2) emotional and mental health pathways, (3) cognitive and behavioral engagement, (4) identity, self-perceptions, and sense of control, and (5) contextual and structural modifiers. These themes collectively illustrate that sensory impairment influences cognition not only through neurobiological pathways but also through complex psychosocial processes operating across individual, interpersonal, and societal levels. Overall, findings support a multifactorial framework in which hearing and vision impairment contributes to downstream psychosocial changes that may accelerate cognitive vulnerability in later life.

Conclusions: The literature demonstrates consistent associations between hearing and vision impairment and cognitive function among older adults, with emerging evidence that psychosocial factors partially explain this relationship. However, the field remains limited, with limited longitudinal mediation analyses and few studies integrating multiple pathways. Future research should prioritize theory-driven models, standardized measurement of sensory function and cognition, and longitudinal designs to clarify causal mechanisms. Interventions targeting depression, social engagement, perceived control, and activity participation may represent promising strategies to mitigate cognitive risk among older adults with sensory impairment.

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