The impact of declining senses on older adults

When older people begin to develop sensory disabilities, their mental health can also decline, according to new research.

The majority of people experience at least some dulling of their senses as they age — for instance, they may find themselves squinting at screens, craving stronger flavours, and missing snatches of conversations with increasing regularity.

Researchers at the University of Chicago Medicine have been looking into how these changes can go beyond mere inconvenience and actually worsen overall mental health in older adults.

“When your senses decline, you can’t experience the world as well,” said Jayant Pinto, a physician and expert in olfactory dysfunction at UChicago Medicine.

“You can’t hear colleagues or friends at the dinner table; you can’t discern what’s going on in your environment; you may have a hard time reading or making things out when you’re in your neighbourhood. It makes all your cognitive burdens a little harder, and that probably wears you down over time and causes mental health problems.”

Along with Alexander Wang, a medical student at the UChicago Pritzker School of Medicine, Pinto recently led a study examining the prevalence and impact of sensory impairments among older adults. They found that people with sensory disabilities tend to have worse mental health, and that different types of sensory disability were associated with different aspects of mental health.

What the data shows

The UChicago researchers analysed data on sensory function (vision, hearing and sense of smell) and self-reported mental health from nearly 4000 older adults, collected over 10 years of follow-up as part of the National Social Life, Health & Aging Project. They found that people who had multiple senses impaired experienced more loneliness and had significantly worse self-reported mental health overall, and people with three sensory disabilities were more likely to experience frequent depressive episodes. In analyses that differentiated between the senses, vision impairment was most strongly associated with both loneliness and poor self-rated mental health.

Scientists are still exploring how changes in all five senses can impact people, but the UChicago researchers can already point to many ways sensory decline contributes directly to feelings of loneliness, sadness and boredom.

Older people with vision impairment may have trouble getting out of the house or seeing the faces of their friends and family, and hearing loss can make conversations stilted and frustrating. Even loss of smell can affect someone’s ability to find joy in familiar scents.

The importance of care in an aging society

According to the researchers, study results highlight the importance of improving access to mental health services and increasing awareness of the connection between sensory loss and mental distress. In particular, understanding how different sensory disabilities impact the long-term mental health of older adults could help healthcare professionals — especially primary care providers, otolaryngologists and ophthalmologists — screen for mental health conditions when they identify sensory loss in their patients, providing opportunities for personalised and timely interventions.

In addition to proactively treating older adults’ mental health, the researchers pointed to steps that can be taken to directly lessen the day-to-day effects of sensory difficulties, which would in turn lessen their negative mental health implications.

On a personal level, family members and friends can help by being patient and finding ways to communicate more effectively, such as speaking clearly or using written notes. On a societal level, public policies and community programs can ensure accessibility in public spaces and provide resources that improve quality of life.

The researchers also highlighted a wide range of technologies and medical interventions are available that can help compensate for sensory impairment.

“In many cases, we can mitigate sensory difficulties in ways that might actually improve people’s lives, mental health and sense of loneliness — which is a huge epidemic,” Pinto said.

“These are simple ways we can intervene to help people and potentially have a huge impact on society.”

Recognising sensory impairments as disabilities and acknowledging their impact on mental health are important steps towards more comprehensive and compassionate care. By addressing the medical, social and environmental barriers that exacerbate these impairments, clinicians — and society as a whole — can better support older adults in maintaining their independence.

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