Sensory impairments, loneliness, and quality of life among middle-aged and older Europeans: the mediating roles of depressive symptoms and activity participation

OBJECTIVES: To examine how sensory impairments are associated with loneliness and quality of life (QoL) over time, and to assess the mediating roles of depressive symptoms and activity participation. METHOD: A longitudinal study including 83,459 participants who took part in at least two waves of the Survey of Health, Ageing and Retirement in Europe (2011-2022). Mixed-effects linear regression models were used, adjusting for socio-demographic and health-related factors. RESULTS: Sensory impairments were associated with increased loneliness and reduced QoL. For vision impairment (VI), loneliness increased (coef. = 0.13, 95% CI: 0.11; 0.15) and QoL decreased (coef. = -1.01, 95% CI: -1.10; -0.92). Hearing impairment (HI) showed similar patterns (loneliness: 0.11, 95% CI: 0.08; 0.14; QoL: -0.76, 95% CI: -0.88; -0.64), while dual sensory impairment (DSI) showed the strongest associations (loneliness: 0.30, 95% CI: 0.26; 0.33; QoL: -2.18, 95% CI: -2.32; -2.04). Depressive symptoms were the most prominent mediator, while activity participation mediated only the associations with VI and DSI. Associations were strongest for HI and loneliness, and DSI and QoL, in women. Loneliness associations were most pronounced in Northern and Western Europe. CONCLUSION: Addressing depressive symptoms may be key to mitigating loneliness and reduced QoL in older adults with sensory impairments.