Date of Award


Document Type

Campus Access Dissertation

Degree Name

Doctor of Philosophy (PhD)



First Advisor

Jeffrey A. Burr

Second Advisor

Qian Song

Third Advisor

Joshua R. Ehrlich


Sensory (vision and hearing) loss is a contributor to poor mental health, a variety of physical health outcomes, and a lower quality of life for older adults. As the population ages, the number of older adults with sensory loss and the number of caregivers needed to provide care are expected to increase accordingly, which will have substantial public health implications. Using data from the National Health and Aging Trends Study, and its sister-study, the National Study of Caregiving, this dissertation investigated how sensory difficulty is related to incident dementia and mortality risk among older adults and how care recipients’ sensory difficulty is related to caregiving experiences. This dissertation consists of three separate studies. Study 1 explored the relationship between sensory difficulty, incident dementia, and social and physical activities among older adults. Results from the structural equation modeling-based discrete-time survival mediation model showed that compared to older adults without sensory difficulty, those with visual difficulty or dual sensory difficulty had a higher risk of dementia. Social activity significantly mediated the visual difficulty-dementia link and the dual sensory difficulty-dementia link. Study 2 investigated the relationship between visual difficulty, recurrent falls, and mortality risk among older adults. Results from the discrete-time survival models showed that having visual difficulty at baseline was associated with a higher risk of recurrent falls in the following wave and a higher mortality risk in the subsequent waves. Visual difficulty was related to increased mortality risk via recurrent falls among older adults. Study 3 examined the relationship between older care recipients’ sensory difficulty and caregiver burden experienced by their informal caregivers. Results from linear regression models showed that caregivers of older adults with dual sensory difficulty report more care burden than caregivers of older adults with no sensory difficulty. Moreover, caregivers of older adults with co-occurring dual sensory difficulty and dementia experienced a higher caregiver burden than those of older adults without dual sensory difficulty or dementia. Focusing on a rising public concern among older adults, this dissertation contributes to the research on aging and sensory health. Findings from three studies provided important insights for promoting interventions for older adults with sensory loss and their caregivers.


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