Declining senses can affect mental health and loneliness in older adults

To 94% of American adultsAdults experience at least some clouding of their senses as they age, squinting at screens more often, craving stronger flavors, and missing snippets of conversations more often. Researchers at the University of Chicago Medicine are investigating how these changes could go beyond mere discomfort and actually worsen the overall mental health of older adults.

“When your senses deteriorate, you can’t perceive the world as well,” says Jayant Pinto, a physician and expert in olfactory disorders at UChicago Medicine.

“You can’t hear your coworkers or friends at the dinner table; you can’t make out what’s going on around you; you might have trouble reading or understanding things when you’re around them. It makes all of your cognitive loads a little bit heavier, and that’s likely to wear you out over time and cause mental health issues.”

Pinto, along with Alexander Wang, a medical student at the University of Chicago Pritzker School of Medicine, recently led a study research into the prevalence and impact of sensory impairment in the elderly.

They found that people with sensory impairments tend to have poorer mental health, and that different types of sensory impairments were associated with different aspects of mental health. The findings are published in the Journal of the American Geriatrics Society.

Revealing associations between perception and emotion

The UChicago researchers analyzed data on sensory function (vision, hearing and smell) and self-reported mental health from nearly 4,000 older adults, collected over a 10-year follow-up as part of the National Social Life, Health & Elderly Project.

They found that people with multisensory impairment felt lonelier and had significantly poorer mental health overall. People with three sensory impairments were also more likely to experience depressive episodes.

Analyses that distinguished between the senses found that visual impairment was most strongly associated with both loneliness and poor mental health.

Scientists are still investigating how changes in all five senses can affect people, but University of Chicago researchers can already point to several ways in which sensory decline directly contributes to feelings of loneliness, sadness and boredom.

Seniors with visual impairment may have difficulty leaving the house or seeing the faces of friends and family, and hearing loss can make conversations wooden and frustrating. Even the loss of smell can affect a person’s ability to find joy in familiar scents—such as a favorite home-cooked meal or a loved one’s signature perfume—and to perceive pheromones, which (although not consciously registered) contribute to social dynamics.

“We found that hearing and vision impairments were often associated with lower self-reported mental health and feelings of loneliness, but smell impairment had a weaker association,” Wang said. “This struck me because hearing and vision impairments tend to be much more stigmatized than smell impairments. This got me thinking about the ways in which social stigma might be driving this poorer mental health.”

Caring for each other in an ageing society

The researchers stress that given the stigma, it is important to improve access to mental health care and raise awareness about the link between sensory loss and mental health problems.

Understanding how different sensory impairments impact the long-term mental health of older adults can help healthcare professionals, especially primary care providers, ear, nose and throat specialists, and ophthalmologists, to screen for mental health conditions when they identify sensory loss in their patients, providing opportunities for personalized and timely interventions.

In addition to proactively addressing older adults’ mental health, the researchers pointed to steps that can be taken to directly reduce the day-to-day effects of sensory issues, which in turn would reduce the negative impact on mental health.

“We have an aging society; everyone has a family member who is getting older and having a harder time in life. It’s a burden we all have to share,” Pinto said. “Easing the burden on your aging family members and friends can have a huge impact on people’s lives, their productivity and their quality of life.”

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, government policies and community programs can provide accessibility in public spaces and provide resources that improve quality of life.

Pinto also emphasized that there are a wide range of technologies and medical interventions available that can help compensate for sensory impairment. For hearing loss, there are cochlear implants, hearing aids and other hearing-assisting devices, which research has shown can slow cognitive decline and also improve quality of life.

For vision loss, there are glasses, contact lenses, cataract surgery and LASIK surgery, along with modifications such as text-to-speech computer programs. Even for the sense of smell, health experts can sometimes help by reducing sinusitis or performing smell-training exercises.

“In many cases, we can mitigate sensory issues in ways that can actually improve people’s lives, their mental health, their sense of loneliness, which is a huge epidemic,” Pinto said. “These are simple ways that we can intervene to help people and potentially have a huge impact on society.”

Recognizing and destigmatizing sensory impairments

The researchers said they intentionally used the word “disability” throughout the article to emphasize the significant impact sensory impairment has on individuals’ lives. This terminology also aligns with efforts to destigmatize these conditions and promote a more inclusive approach to health care.

“To some extent, our society already views reduced sensory function as a disability: think of the blind and deaf communities, for example,” Wang said.

“Like many marginalized communities, the disability community has historically had a very contentious relationship with the medical field, which can create stress and limit access to mental health care. With greater understanding and compassion, we can strive to improve the care we provide to older adults and those with disabilities.”

He said that by analyzing the data in this way, he hopes more health care providers will be encouraged to move away from the medical model of disability and toward the social model of disability.

“I understand that the medical model characterizes disability as something that is ‘flawed’ in a person, and thus requires some kind of ‘fixing’ of the individual,” he explained. “The social model characterizes disability more as an identity, so disability-related limitations arise from the lack of accessibility and disability accommodations in a society.”

Recognizing sensory impairment as a disability and acknowledging its impact on mental health are important steps toward more comprehensive and compassionate care.

By addressing the medical, social, and environmental barriers that exacerbate these limitations, clinicians (and society as a whole) can better support older adults in maintaining their independence.