Sensory impairments and loneliness among older Europeans: Insights from a cross-national longitudinal study

Sensory impairments are linked to loneliness, but the reasons are not well understood. This study aims to investigate the associations between sensory impairments and loneliness over time, considering sex, age, and European regions, and to examine the mediating roles of activity participation, activities of daily living (ADL), depressive symptoms, quality of life (QoL), cognitive function, and social network. We conducted a cohort study of 83,329 Europeans aged 50 + years, participating in at least two waves of the Survey of Health, Ageing and Retirement in Europe (SHARE) from 2011–2022. Loneliness was measured on a scale from 3–9. Mixed-effects regression models with sex-interactions, adjusting for socio-demographic factors and medical history, were used. Compared to those with good vision and hearing, individuals with vision impairment (VI) (coef. = 0.12, 95% CI: 0.10; 0.14), hearing impairment (HI) (coef. = 0.11, 95% CI: 0.08; 0.14), and dual sensory impairment (DSI) (coef. = 0.28, 95% CI: 0.25; 0.31) had a higher risk of loneliness. Dose-response relationships were observed in all associations. Most associations were consistent across sex and age groups, but the association with HI was strongest for females up to age 79 years but only observed in males thereafter. Associations varied across Europe, with the strongest associations in Northern Europe for females with VI and males with HI. For DSI, the associations were mainly mediated by activity participation (17.4%), depressive symptoms (17.3%), and QoL (16.6%). To mitigate the effect of sensory impairments on loneliness, particularly limitations in activity participation should be targeted.