Sensory and cognitive contributions to everyday functioning in later life: The role of social determinants of health over time

OBJECTIVES: A reduction in an aging individual's abilities combined with environmental changes can lead to decline in everyday function. This study examined the association between visual and cognitive abilities with everyday function and assessed whether measures of Social Determinants of Health (SDoH) moderate the associations of these predictors with activities of daily living (ADLs) and instrumental activities of daily living (IADLs). METHODS: Using a generalized linear mixed model, the longitudinal associations between changes in vision, cognitive function, and everyday functioning were examined. RESULTS: Decline in reasoning abilities was associated with more ADL limitations, and the association was stronger for older adults with decreased healthcare access and lower economic stability. Furthermore, the associations between memory and speed of processing were associated with more ADL limitations, and the associations were stronger for older adults with lower educational and occupational status. Also, better memory was associated with fewer IADL limitations, and this association was weaker for older adults with higher educational and occupational status, and social and community contexts. CONCLUSION: Interventions to enhance cognitive abilities and modify environmental resources are essential to alleviate IADL/ADL limitations in older age.