Table 3.
Association of vision and hearing status with depressive symptoms among middle-aged and older Chinese adults.
| Vision and hearing status (No.) | Outcome case, No (%) | Depressive symptome HR (95% CI) | |||
|---|---|---|---|---|---|
| Model 0 a | Model 1 b | Model 2 c | Model 3 d | ||
| Eyesight for seeing things at a distance | |||||
| Excellent (189) | 43 (22.75) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) |
| Very good (1,413) | 376 (26.61) | 1.12 (0.87–1.64) | 1.15 (0.84–1.57) | 1.15 (0.84–1.58) | 1.15 (0.84–1.58) |
| Good (2,693) | 894 (33.20) | 1.56 (1.14–2.11)** | 1.39 (1.02–1.89)* | 1.36 (1.01–1.86)* | 1.37 (1.01–1.86)* |
| Fair (3,732) | 1,303 (34.91) | 1.66 (1.22–2.24)** | 1.43 (1.05–1.94)* | 1.37 (1.02–1.87)* | 1.38 (1.02–1.87)* |
| Poor (1,465) | 622 (42.46) | 2.15 (1.57–2.93)*** | 1.71 (1.25–2.33)*** | 1.59 (1.17–2.17)** | 1.59 (1.16–2.17)** |
| Eyesight for seeing things up close | |||||
| Excellent (132) | 33 (25.00) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) |
| Very good (978) | 293 (29.96) | 1.24 (0.87–1.78) | 1.19 (0.83–1.71) | 1.20 (0.84–1.73) | 1.20 (0.84–1.72) |
| Good (2,470) | 827 (33.48) | 1.42 (1.00–2.01) | 1.30 (0.91–1.84) | 1.27 (0.89–1.80) | 1.27 (0.89–1.79) |
| Fair (4,085) | 1,371 (33.56) | 1.43 (1.01–2.02)* | 1.25 (0.89–1.77) | 1.21 (0.86–1.71) | 1.21 (0.86–1.71) |
| Poor (1,827) | 714 (39.08) | 1.59 (1.73–2.46)** | 1.47 (1.04–2.09)* | 1.39 (0.98–1.98) | 1.39 (0.91–1.97) |
| Hearing | |||||
| Excellent (158) | 40 (25.31) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) |
| Very good (1,534) | 438 (28.55) | 1.15 (0.83–1.59) | 1.10 (0.80–1.53) | 1.10 (0.80–1.53) | 1.10 (0.80–1.52) |
| Good (3,221) | 1,042 (32.35) | 1.33 (0.97–1.82) | 1.22 (0.89–1.67) | 1.20 (0.88–1.65) | 1.20 (0.88–1.65) |
| Fair (3,704) | 1,355 (36.58) | 1.56 (1.14–2.13)** | 1.40 (1.02–1.91)* | 1.33 (0.97–1.83) | 1.33 (0.97–1.83) |
| Poor (875) | 363 (41.49) | 1.82 (1.31–2.53)*** | 1.58 (1.14–2.20)** | 1.50 (1.08–2.08)* | 1.49 (1.07–2.07)* |
| Vision and hearing impairment group | |||||
| No vision and hearing impairment (6,463) | 2,043 (31.61) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) |
| Only vision impairment (2,154) | 832 (38.62) | 1.30 (1.19–1.40)*** | 1.18 (1.09–1.28)*** | 1.14 (1.05–1.24)** | 1.14 (1.05–1.24)** |
| Only hearing impairment (407) | 161 (40.15) | 1.31 (1.12–1.54)*** | 1.27 (1.08–1.49)** | 1.25 (1.06–1.47)** | 1.24 (1.06–1.46)** |
| Both vision and hearing impairment (468) | 202 (43.16) | 1.49 (1.29–1.73)*** | 1.33 (1.15–1.54)*** | 1.25 (1.08–1.45)** | 1.25 (1.08–1.45)** |
| Risk factors f | |||||
| Age | 1.00 (0.99–1.00) | 1.00 (0.99–1.00) | 1.00 (0.99–1.00) | ||
| Gender | |||||
| Male | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | ||
| Female | 1.52 (1.41–1.64)*** | 1.42 (1.28–1.58)*** | 1.42 (1.28–1.58)*** | ||
| Residence | |||||
| Urban | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | ||
| Rural | 0.71 (0.66–0.76)*** | 0.71 (0.66–0.76)*** | 0.71 (0.65–0.76)*** | ||
| Education level | |||||
| Illiterate | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | ||
| Elementary school and below | 0.92 (0.84–1.00) | 0.91 (0.83–0.99)* | 0.90 (0.83–0.99)* | ||
| Middle school | 0.71 (0.63–0.79)*** | 0.71 (0.64–0.80)*** | 0.71 (0.63–0.79)*** | ||
| High school and above | 0.50 (0.43–0.57)*** | 0.50 (0.43–0.57)*** | 0.49 (0.43–0.57)*** | ||
| Marital status | |||||
| Married/cohabiting | 1.00 (Reference) | 1.00 (Reference) | 1.00 (Reference) | ||
| Separated/divorced/widowed/never married | 1.04 (0.92–1.17) | 1.04 (0.93–1.18) | 1.04 (0.93–1.18) | ||
| Smoking history | |||||
| Yes | 1.05 (0.95–1.16) | 1.05 (0.95–1.16) | |||
| No | 1.00 (Reference) | 1.00 (Reference) | |||
| Alcohol consumption | |||||
| Drink more than once a month | 1.15 (1.00–1.34) | 1.15 (0.99–1.33) | |||
| Drink but less than once a month | 1.22 (1.10–1.34)*** | 1.22 (1.10–1.34)*** | |||
| None of these | 1.00 (Reference) | 1.00 (Reference) | |||
| Hypertension | |||||
| Yes | 1.03 (0.95–1.13) | 1.03 (0.95–1.13) | |||
| No | 1.00 (Reference) | 1.00 (Reference) | |||
| Diabetes | |||||
| Yes | 1.21 (1.03–1.41)* | 1.21 (1.03–1.41)* | |||
| No | 1.00 (Reference) | 1.00 (Reference) | |||
| Heart disease | |||||
| Yes | 1.07 (0.96–1.21) | 1.07 (0.96–1.21) | |||
| No | 1.00 (Reference) | 1.00 (Reference) | |||
| Digestive disease | |||||
| Yes | 1.21 (1.11–1.32)*** | 1.21 (1.11–1.31)*** | |||
| No | 1.00 (Reference) | 1.00 (Reference) | |||
| Arthritis | |||||
| Yes | 1.29 (1.20–1.39)*** | 1.29 (1.20–1.39)*** | |||
| No | 1.00 (Reference) | 1.00 (Reference) | |||
| Wearing glasses | |||||
| Yes | 1.02 (0.91–1.15) | ||||
| No | 1.00 (Reference) | ||||
| Wearing hearing aids | |||||
| Yes | 1.25 (0.76–2.05) | ||||
| No | 1.00 (Reference) | ||||
HR, hazard ratio; CI, confidence interval.
*
0.01 < P-value < 0.05,
**
0.001 < P-value < 0.01,
***
P-value < 0.001.
a
Model 0 was unadjusted.
b
Model 1 was adjusted for age, sex, residence, marital status, and educational level.
c
Model 2 was adjusted for age, sex, residence, marital status, educational level, smoking history, alcohol consumption, hypertension, diabetes, heart disease, digestive disease, and arthritis.
d
Model 3 was adjusted for age, sex, residence, marital status, educational level, smoking history, alcohol consumption, hypertension, diabetes, heart disease, digestive disease, arthritis, wearing glasses, and wearing hearing aids.
e
Defined as a score of 12 or greater on the 10-item Center for Epidemiologic Studies Depression scale.
f
Hazard ratio on the risk factors of vision and hearing impairment group.