Cognitive Function and Decline Among Older Adults: The Roles of Sensory Loss and Psychosocial Factors

In the context of rapid global aging, cognitive decline among older adults has become a major public health and social issue. A better understanding of the risk factors for cognitive decline is important for developing interventions to preserve cognitive function among older adults. Knowledge gaps still exist in understanding the impact of sensory loss (i.e., hearing loss and vision loss) and psychosocial factors (i.e., social support and loneliness) on cognitive function and cognitive decline. This dissertation aims to fill these knowledge gaps by (1) examining the relationship between psychosocial factors and cognitive function in a unique population: community-dwelling Chinese older adults in the United States (U.S.); (2) understanding the longitudinal relationship between sensory loss and cognitive decline among community-dwelling older adults in the United States; and (3) exploring the mechanisms that accelerate or decelerate cognitive decline by examining the inter-relationships between sensory loss, psychosocial factors, and cognitive decline. The primary study conducted for this dissertation used structural equational modeling (SEM) to model the potential moderation or mediation effect of psychosocial factors on the relationship between sensory loss and cognitive decline over time. Findings from this dissertation deepen our understanding of the important roles that social support, loneliness, and sensory loss can play in cognitive function and decline among community-dwelling older adults. Findings from this dissertation also highlight the importance of adequately addressing the physical and psychological challenges encountered by older adults. Subsequent recommendations are provided to health providers and policy makers to help better preserve and promote cognitive health among older adults using a more holistic approach.