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...
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BMC
2025-07-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-025-06173-4 |
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| 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 |
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