# The impact of visual and hearing impairments on the risk of arthritis among middle-aged and older Chinese adults (2011–2015): the mediating role of depressive symptoms

## TL;DR

This study finds that visual and hearing impairments increase the risk of arthritis in older Chinese adults, partly due to depressive symptoms.

## Contribution

The study identifies depressive symptoms as a partial mediator linking sensory impairments to arthritis risk in older adults.

## Key findings

- Visual, hearing, and dual sensory impairments are each associated with higher odds of developing arthritis.
- Depressive symptoms partially explain the increased arthritis risk in those with sensory impairments.
- The mediation effect was strongest for hearing impairment, accounting for 12.70% of the association.

## Abstract

To date, the mechanisms underlying the relationship between sensory impairment and new-onset arthritis remain inadequately understood. This study aims to investigate the mediating role of depressive symptoms in the longitudinal association between sensory impairment and new-onset arthritis, specifically focusing on visual impairment (VI), hearing impairment (HI), and dual sensory impairment (DSI).

This study aimed to elucidate the associative dynamics between various sensory impairments and the risk of developing new-onset arthritis, with a specific focus on the mediating influence of depressive symptoms. By understanding these interconnections, we seek to provide insights that could inform targeted interventions aimed at mitigating arthritis onset in older adults.

Utilizing data derived from the 2011 China Health and Retirement Longitudinal Study (CHARLS), a cohort of 8,415 participants aged 45 years and older was analyzed. Participants were categorized based on their sensory status into four groups: no impairment, VI only, HI only, and DSI. A multivariate logistic regression analysis was employed to assess the association between sensory impairments and the incidence of arthritis over a four-year follow-up period, supplemented by subgroup analyses and mediation analysis to explore the mediating role of depressive symptoms.

Among 8,415 participants who were free of arthritis at baseline (2011), 1,554 developed arthritis by 2015. In fully adjusted models, visual impairment (VI), hearing impairment (HI), and dual sensory impairment (DSI) were each found to be associated with higher odds of incident arthritis (VI: aOR = 1.32; HI: aOR = 1.39; DSI: aOR = 1.34). In a four-category analysis, using individuals with no sensory impairment as the reference group, the results indicated that VI only (aOR = 1.29, 95% CI 1.07–1.56), HI only (aOR = 1.60, 95% CI 1.21–2.12), and DSI (aOR = 1.65, 95% CI 1.38–1.96) were associated with elevated risks. Mediation analysis revealed that depressive symptoms partially explained these associations, accounting for 18.28% of the VI–arthritis association, 12.70% for HI, and 15.69% for DSI. The findings were consistent across secondary analyses.

The findings of this study highlight that sensory impairments are significantly associated with an increased risk of arthritis among older Chinese adults, with depressive symptoms serving as a partial mediator. These results underscore the importance of integrating mental health management into the care strategies for individuals with sensory disabilities. Future research should explore intervention strategies aimed at addressing both sensory impairments and mental health to further reduce the incidence of arthritis in this vulnerable demographic.

The online version contains supplementary material available at 10.1186/s12889-025-25495-x.