The association between dual sensory impairment and social participation among older adults in China: a moderated mediation model of activities of daily living and depressive symptoms

Abstract Background While dual sensory impairment (DSI) is known to reduce social participation (SP) in older adults, the underlying mechanisms remain unclear. Therefore, the aim of this study was to ascertain: (1) whether ADL mediates the relationship between DSI and SP, and (2) how depressive symp...

Full description

Saved in:
Bibliographic Details
Main Authors: Lunxin Liu, Zhenglin Cao, Qingshan MA, Zhiliu Liao
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Geriatrics
Subjects:
Online Access:https://doi.org/10.1186/s12877-025-06173-4
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849388733250404352
author Lunxin Liu
Zhenglin Cao
Qingshan MA
Zhiliu Liao
author_facet Lunxin Liu
Zhenglin Cao
Qingshan MA
Zhiliu Liao
author_sort Lunxin Liu
collection DOAJ
description Abstract Background While dual sensory impairment (DSI) is known to reduce social participation (SP) in older adults, the underlying mechanisms remain unclear. Therefore, the aim of this study was to ascertain: (1) whether ADL mediates the relationship between DSI and SP, and (2) how depressive symptoms modify the mediation pathway - questions essential for developing targeted interventions. Methods In the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS), 8,270 older individuals (60 years of age or older) were enrolled. We examined a mediation model first, where ADL was a mediator between DSI and SP. Furthermore, depressive symptoms were integrated into the model as moderator in the correlation between DSI and ADL. The PROCESS macro was used to analyze the mediation and moderated mediation models. Results In older people, DSI correlated negatively with SP, and ADL partially mediated this association (B = -0.019, 95% CI = -0.025, -0.015) with an intermediary effect of 14.6%. Besides, the relationship between DSI and ADL was moderated by depressive symptoms (B = 0.092, 95% CI = 0.060, 0.123), and ADL was more affected by DSI in older adults who experienced higher levels of depressive symptoms. Conclusions Depressive symptoms moderated the mediation of ADL on an indirect, negative correlation between DSI and SP. The findings contribute to existing knowledge by illustrating the fundamental mechanisms connecting DSI and SP. These Findings highlight the need for integrated interventions targeting both sensory impairment and mental health to mitigate SP decline in aging populations.
format Article
id doaj-art-d7e0db0aeae74045893043eaede4a33a
institution Kabale University
issn 1471-2318
language English
publishDate 2025-07-01
publisher BMC
record_format Article
series BMC Geriatrics
spelling doaj-art-d7e0db0aeae74045893043eaede4a33a2025-08-20T03:42:10ZengBMCBMC Geriatrics1471-23182025-07-0125111110.1186/s12877-025-06173-4The association between dual sensory impairment and social participation among older adults in China: a moderated mediation model of activities of daily living and depressive symptomsLunxin Liu0Zhenglin Cao1Qingshan MA2Zhiliu Liao3School of Public Health, Chongqing Medical UniversityChongqing Intellectual Property School, Chongqing University of TechnologySchool of Economics, Xiamen UniversitySchool of Public Health, Chongqing Medical UniversityAbstract Background While dual sensory impairment (DSI) is known to reduce social participation (SP) in older adults, the underlying mechanisms remain unclear. Therefore, the aim of this study was to ascertain: (1) whether ADL mediates the relationship between DSI and SP, and (2) how depressive symptoms modify the mediation pathway - questions essential for developing targeted interventions. Methods In the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS), 8,270 older individuals (60 years of age or older) were enrolled. We examined a mediation model first, where ADL was a mediator between DSI and SP. Furthermore, depressive symptoms were integrated into the model as moderator in the correlation between DSI and ADL. The PROCESS macro was used to analyze the mediation and moderated mediation models. Results In older people, DSI correlated negatively with SP, and ADL partially mediated this association (B = -0.019, 95% CI = -0.025, -0.015) with an intermediary effect of 14.6%. Besides, the relationship between DSI and ADL was moderated by depressive symptoms (B = 0.092, 95% CI = 0.060, 0.123), and ADL was more affected by DSI in older adults who experienced higher levels of depressive symptoms. Conclusions Depressive symptoms moderated the mediation of ADL on an indirect, negative correlation between DSI and SP. The findings contribute to existing knowledge by illustrating the fundamental mechanisms connecting DSI and SP. These Findings highlight the need for integrated interventions targeting both sensory impairment and mental health to mitigate SP decline in aging populations.https://doi.org/10.1186/s12877-025-06173-4Dual sensory impairmentSocial participationActivities of daily livingDepressive symptomsModerated mediation
spellingShingle Lunxin Liu
Zhenglin Cao
Qingshan MA
Zhiliu Liao
The association between dual sensory impairment and social participation among older adults in China: a moderated mediation model of activities of daily living and depressive symptoms
BMC Geriatrics
Dual sensory impairment
Social participation
Activities of daily living
Depressive symptoms
Moderated mediation
title The association between dual sensory impairment and social participation among older adults in China: a moderated mediation model of activities of daily living and depressive symptoms
title_full The association between dual sensory impairment and social participation among older adults in China: a moderated mediation model of activities of daily living and depressive symptoms
title_fullStr The association between dual sensory impairment and social participation among older adults in China: a moderated mediation model of activities of daily living and depressive symptoms
title_full_unstemmed The association between dual sensory impairment and social participation among older adults in China: a moderated mediation model of activities of daily living and depressive symptoms
title_short The association between dual sensory impairment and social participation among older adults in China: a moderated mediation model of activities of daily living and depressive symptoms
title_sort association between dual sensory impairment and social participation among older adults in china a moderated mediation model of activities of daily living and depressive symptoms
topic Dual sensory impairment
Social participation
Activities of daily living
Depressive symptoms
Moderated mediation
url https://doi.org/10.1186/s12877-025-06173-4
work_keys_str_mv AT lunxinliu theassociationbetweendualsensoryimpairmentandsocialparticipationamongolderadultsinchinaamoderatedmediationmodelofactivitiesofdailylivinganddepressivesymptoms
AT zhenglincao theassociationbetweendualsensoryimpairmentandsocialparticipationamongolderadultsinchinaamoderatedmediationmodelofactivitiesofdailylivinganddepressivesymptoms
AT qingshanma theassociationbetweendualsensoryimpairmentandsocialparticipationamongolderadultsinchinaamoderatedmediationmodelofactivitiesofdailylivinganddepressivesymptoms
AT zhiliuliao theassociationbetweendualsensoryimpairmentandsocialparticipationamongolderadultsinchinaamoderatedmediationmodelofactivitiesofdailylivinganddepressivesymptoms
AT lunxinliu associationbetweendualsensoryimpairmentandsocialparticipationamongolderadultsinchinaamoderatedmediationmodelofactivitiesofdailylivinganddepressivesymptoms
AT zhenglincao associationbetweendualsensoryimpairmentandsocialparticipationamongolderadultsinchinaamoderatedmediationmodelofactivitiesofdailylivinganddepressivesymptoms
AT qingshanma associationbetweendualsensoryimpairmentandsocialparticipationamongolderadultsinchinaamoderatedmediationmodelofactivitiesofdailylivinganddepressivesymptoms
AT zhiliuliao associationbetweendualsensoryimpairmentandsocialparticipationamongolderadultsinchinaamoderatedmediationmodelofactivitiesofdailylivinganddepressivesymptoms