RESUMEN
OBJECTIVE: This study sought to develop and validate a 6-year risk prediction model in older adults with cognitive frailty (CF). METHODS: In the secondary analysis of Chinese Longitudinal Healthy Longevity Survey (CLHLS), participants from the 2011-2018 cohort were included to develop the prediction model. The CF was assessed by the Chinese version of Mini-Mental State Exam (CMMSE) and the modified Fried criteria. The stepwise regression was used to select predictors, and the logistic regression analysis was conducted to construct the model. The model was externally validated using the temporal validation method via the 2005-2011 cohort. The discrimination was measured by the area under the curve (AUC), and the calibration was measured by the calibration plot. A nomogram was conducted to vividly present the prediction model. RESULTS: The development dataset included 2420 participants aged 60 years or above, and 243 participants suffered from CF during a median follow-up period of 6.91 years (interquartile range 5.47-7.10 years). Six predictors, namely, age, sex, residence, body mass index (BMI), exercise, and physical disability, were finally used to develop the model. The model performed well with the AUC of 0.830 and 0.840 in the development and external validation datasets, respectively. CONCLUSION: The study could provide a practical tool to identify older adults with a high risk of CF early. Furthermore, targeting modifiable factors could prevent about half of the new-onset CF during a 6-year follow-up.
Asunto(s)
Trastornos del Conocimiento , Cognición , Fragilidad , Anciano , Humanos , Pueblo Asiatico , Índice de Masa Corporal , Ejercicio Físico , Fragilidad/diagnóstico , Fragilidad/psicología , Trastornos del Conocimiento/diagnósticoRESUMEN
With the aging population in China, health issues among the elderly are becoming increasingly prominent, leading to a rapidly growing demand for health interventions for the elderly. Exergames are one of the important emerging methods in the field of health interventions for the elderly, widely used and yielding positive results. While research on exergames is well-established abroad, it is still in its infancy in China, lacking reports on the types, interaction forms, intervention content, application status, and effectiveness of exergames. Exergames are suitable for widespread use among the elderly in China, and there is a need to accelerate the development and application of exergames in the field of health interventions for the elderly in China.
Asunto(s)
Juegos de Video , Humanos , Anciano , China , Ejercicio Físico , Terapia por Ejercicio/métodosRESUMEN
BACKGROUND: Urinary incontinence is an increasingly common problem, especially among older people in nursing homes. Nursing assistants are the leading workforce in nursing homes, and their knowledge and attitudes regarding urinary incontinence have garnered considerable attention in the context of aging in China. However, most previous studies on this issue have focused on registered nurses. This study aimed to explore nursing assistants' knowledge, attitudes and training needs with regard to urinary incontinence. METHODS: We conducted a two-part mixed-methods study. After institutional manager approval, we surveyed the knowledge and attitudes of 509 nursing assistants regarding urinary incontinence. We carried out semi-structured interviews with 40 nursing assistants to elicit detailed information on training needs. RESULTS: In general, knowledge about urinary incontinence was poor (14.00 ± 4.18), although attitudes were primarily positive (35.51 ± 3.19). Most nursing assistants were very willing to learn more about urinary incontinence (93.9%, 478/509), but time constraints and low educational background may be barriers to learning motivation. The three preferred training styles among nursing assistants were face-to-face guidance from a mentor, training combining theory with practice, and online video training. CONCLUSIONS: Chinese nursing assistants had poor knowledge but positive attitudes toward urinary incontinence. Facility managers should focus on developing training and learning mechanisms regarding urinary incontinence. It is important to adopt diverse training styles according to the actual situation of nursing homes.
Asunto(s)
Asistentes de Enfermería , Incontinencia Urinaria , Humanos , Anciano , Conocimientos, Actitudes y Práctica en Salud , Casas de Salud , Incontinencia Urinaria/diagnóstico , Incontinencia Urinaria/terapia , Encuestas y Cuestionarios , Asistentes de Enfermería/educaciónRESUMEN
Hospitalized patients who lose one or more activities of daily living at the time of discharge compared with 2 weeks before admission (before acute onset) are referred to as hospitalization-associated disability (HAD). The incidence of HAD is high among elderly patients, which leads to the increased readmission rates, long-term care rates, and mortality, bringing a huge burden on patients, families, and society. It is vital for doctors and nurses to identify the risk factors of HAD of the elderly patients and take targeted intervention measures to prevent and improve HAD. At present, the research on HAD in foreign countries is relatively perfect, while the research on HAD in China is still in its infancy, and there is still lack of systematic research and reports on the incidence, influencing factors, and intervention measures of HAD. Domestic clinical nursing practice can learn from foreign mature interventions, carry out cultural adjustment, create a friendly environment in the hospital for elderly patients, pay attention to the assessment of the influencing factors of HAD in elderly patients, and provide personalized and patient-centered nursing measures for hospitalized elderly patients according to the assessment results, maintain their function during hospitalization and prevent the occurrence of HAD.
Asunto(s)
Actividades Cotidianas , Personas con Discapacidad , Humanos , Anciano , Hospitalización , Hospitales , Factores de RiesgoRESUMEN
Engaging in physical activity and exercise is one of the important ways for health promotion. However, older adults are often physically inactive or have a sedentary lifestyle and have poor compliance with physical activity. Exergaming program with their unique advantages could make physical activity a more joyful experience and motivate older adults to participate in physical activity. Promoting older adults' health through engagement in exergaming programs is still in the early stage, and still faces many challenges. Analyzing the challenges and difficulties faced by exergaming program for older adults and exploring in-depth strategies to promote the implementation of exergaming program for older adults are of great significance for the design and implementation of sports games for older adults.
Asunto(s)
Ejercicio Físico , Videojuego de EjercicioRESUMEN
OBJECTIVE: this study sought to systematically review and synthesize qualitative data to explore older adult exergame experiences and perceptions. METHODS: a comprehensive search was conducted in seven databases from the earliest available date to May 2022. All qualitative and mixed-method studies available in English and explored exergame experiences in older adults were included. Tools from the Joanna Briggs Institute were used for data extraction and synthesis. Data were extracted using the Capability, Opportunity and Motivation Model of Behaviour (COM-B model) as a guide, and a pragmatic meta-aggregative approach was applied to synthesize the findings. RESULTS: this systematic review identified 128 findings and aggregated 9 categories from the 10 qualitative research articles included, and three synthesized findings were: older adult capability, opportunities in the exergaming program and motivation in the exergaming program. Capability consisted of attitude toward exergames, age- or health-related impairments and exergame knowledge and skills. Opportunities included older adult-friendly exergame design and social influence. Motivation included self-efficacy, support, instruction and feedback, health benefits, as well as unpleasant exergaming experiences. CONCLUSIONS: it is crucial to tailor the exergaming program to suit the older population. We identified barriers and facilitators of implementing exergaming in older adults and found most barriers are surmountable. The results of the current systematic review could provide evidence for the design and implementation of exergaming programs among older adults. The ConQual score of the synthesized findings was assessed as low. Dependability and credibility should be accounted for in future studies to increase confidence.
Asunto(s)
Videojuego de Ejercicio , Humanos , Anciano , Investigación CualitativaRESUMEN
AIMS: The objective of this study was to determine the prevalence of frailty and pain among older adults with physical functional limitations in China. We also assessed the impact of pain and psychosocial determinants on frailty among this vulnerable population. DESIGN: This study was a cross-sectional study. SETTING AND PARTICIPANTS: Totally, 2,323 Chinese elders with physical functional limitation were enrolled. METHODS: Physical functioning was assessed by the Barthel Index, participants who reported "often troubled with pain" were further asked about the intensity of their pain using a 1-10 numeric rating scale, and frailty was assessed by the Assessment of frailty FRAIL scale. The impact of pain and psychosocial factors on frailty was assessed by multivariable binary logistic regression. RESULTS: The prevalence of frailty and pain were 30.9% and 46.1%, respectively. Compared with subjects who reported no pain, those who reported mild (odds ratio [OR] = 1.70, 95% confidence interval [CI] = 1.21-2.31), moderate (OR = 2.10, 95% CI = 1.53-2.82), or severe pain (OR = 2.31, 95% CI = 1.56-3.40) tended to be more vulnerable to frailty. Furthermore, compared with participants with positive psychosocial determinants, those with negative psychosocial determinants seemed more likely to be frail. CONCLUSIONS: These findings suggest that the incidence of pain, negative psychosocial status, and frailty were prevalent, and the presence of pain and negative psychosocial factors increased the risk of frailty among older adults with physical functional limitation.
Asunto(s)
Fragilidad , Anciano , Estudios Transversales , Anciano Frágil/psicología , Fragilidad/complicaciones , Fragilidad/epidemiología , Evaluación Geriátrica , Humanos , Dolor/epidemiología , Dolor/psicología , PrevalenciaRESUMEN
OBJECTIVE: To assess the prevalence and to identify the associated factors of malnutrition among elderly Chinese with physical functional dependency. DESIGN: Face-to-face interviews using standardised questionnaires were conducted to collect demographic information, health-related issues and psychosocial status. Physical function was measured by the Barthel Index (BI), and nutrition status was assessed by the Mini Nutritional Assessment-Short Form. Multivariate binary logistic regression was used to assess associated factors of malnutrition. SETTING: China. PARTICIPANTS: A total of 2323 participants (aged ≥ 60 years) with physical functional dependency in five provinces in China were enrolled using a multistage cluster sampling scheme. RESULTS: The prevalence of malnutrition was 17·9 % (95 % CI 16·3, 19·4). Multivariable binary logistic regression revealed the independent risk factors of poor nutrition status were being female, older age, lower educational status, poor hearing, poor physical functional status, lack of hobbies, low religious participation, poor social support, lack of social participation and changes in social participation. The study found that the most significant independent risk factor for malnutrition was complete physical functional dependence (OR 4·46, 95 % CI 2·92, 6·82). CONCLUSIONS: The findings of the study confirm that malnutrition and the risk of malnutrition are prevalent in Chinese older adults with physical functional dependency. In addition to demographic and physical health-related factors, psychosocial factors, which are often overlooked, are independently associated with nutrition status in Chinese older adults with physical functional dependency. A holistic approach should be adopted to screen for malnutrition and develop health promotion interventions in this vulnerable population.
Asunto(s)
Evaluación Geriátrica , Desnutrición , Anciano , China/epidemiología , Estudios Transversales , Femenino , Humanos , Desnutrición/epidemiología , Evaluación Nutricional , Estado Nutricional , Factores de RiesgoRESUMEN
OBJECTIVE: To explore the perspectives of key stakeholders on necessary factors to implement care quality improvement program. METHODS: We conducted qualitative descriptive research in eight nursing homes in four major prefecture-level cities of Changsha, Xiangtan, Zhuzhou, and Yueyang. Data of 50 clinical nurses and 64 nurse assistants were included and analyzed. Ethical approval was given by the medical ethics committee of Chinese Clinical Trial Registry (No. ChiCTR-IOC-17013109, https://www.chictr.org.cn/index.aspx ). One-to-one interviews were used with the nursing managers, and separate focus group discussions were used with the clinical nurses and nurse assistants. All of the interviews were audio recorded and later transcribed verbatim. In addition, the first author documented the responses of every participant in the field notes during the interviews and focus groups. RESULTS: The participants' perspectives were characterized by two main themes: (1) enablers, with four subthemes of "organizational support", "the evidence-based practice ability", "proactivity", "nursing supervision and feedback;" and (2) barriers, with five sub-themes of "low educational background", "the limitations of self-role orientation", "resistance to change", "lack of job motivation", and "organizational constraints". CONCLUSION: These findings recognize factors at the organizational level, staff level and societal level that are necessary to implement effective mentoring. The results of this study can provide reference for nursing home in improving nursing management quality, formulating, implementing and revising training policies.
Asunto(s)
Casas de Salud , Mejoramiento de la Calidad , China , Humanos , Investigación Cualitativa , Calidad de la Atención de SaludRESUMEN
BACKGROUND: Dementia is a major cause of disability and dependency in older adults worldwide. It is often accompanied by general psychological distress, such as depression and anxiety symptoms, among caregivers of people with dementia (PwD). The physical and mental health of the caregiver is a prerequisite and a promise to help PwD continue to live as long and as well as possible. Web-based interventions can provide convenient and efficient support and an education tool to potentially reduce the negative outcomes associated with providing care. OBJECTIVE: The aim of this study was to examine the effect of internet-based interventions on the mental health outcomes of family caregivers of PwD and to explore which components of the Web-based interventions play an important role. METHODS: A comprehensive literature search was conducted in PubMed, Excerpta Medica dataBASE, PsycINFO, Cochrane Database, and the Cumulative Index to Nursing and Allied Health Literature using relevant terms such as Web-based and caregiver as keywords, covering all studies published before June 2018. A total of 2 reviewers independently reviewed all published abstracts, according to established inclusion and exclusion criteria. We extracted information about the participants, interventions, and results and reviewed article quality in terms of the randomized trial methods, using the approach recommended by the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: A total of 815 caregivers participated in 6 studies, with 4 of the studies using depression as an outcome. The analysis found that depression scores dropped an average of 0.23 (95% CI -0.38 to -0.07; P<.01) after Web-based interventions. In 2 studies of caregivers who were experiencing anxiety symptoms, the average score for anxiety dropped by 0.32 points (95% CI -0.50 to -0.14; P<.01). However, in terms of coping, pain, and stress, the Web-based interventions showed a poor effect. On the whole, the addition of professional psychological support on the basis of education can improve caregivers' mental health. CONCLUSIONS: Internet-based interventions were generally effective at reducing anxiety and depression in dementia caregivers, although negative results were found in some studies. As for burden and stress, further research is required.
Asunto(s)
Cuidadores/psicología , Demencia/terapia , Intervención basada en la Internet/tendencias , Salud Mental/tendencias , Demencia/psicología , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Objective: Electronic mental health interventions are effective but not well promoted currently among older adults. This study sought to systematically review and summarize the barriers and facilitators of accepting and implementing electronic mental health interventions among older adults. Methods: We comprehensively retrieved six electronic databases from January 2012 to September 2022: PubMed, Web of Science, Embase, Scopus, PsycINFO, and CINAHL. The JBI-QARI was used to assess the quality of the research methodology of each publication. Eligible studies underwent data coding and synthesis aligned to inductive and deductive methods. The Consolidated Framework for Implementation Research 2.0 was used as a deductive framework to guide a more structured analysis. Results: The systematic review screened 4309 articles, 17 of which were included (eight with mixed methods and nine with qualitative methods). We identified and extracted the barriers and facilitators of accepting and implementing electronic mental health interventions among older adults: (1) innovation: technology challenges, optimized functions, and contents, security and privacy; (2) outer setting: community engagement and partnerships, financing; (3) inner setting: leadership engagement, available resources, incompatibility, intergenerational support, training and guidance; (4) individuals: perceptions, capability, motivation of older adults and healthcare providers; and (5) implementation process: recruit, external assistance, and team. Conclusion: These findings are critical to optimizing, promoting, and expanding electronic mental health interventions among older adults. The systematic review also provides a reference for better evidence-based implementation strategies in the future.
RESUMEN
BACKGROUND: Maintaining physical function is critical for older adults to achieve healthy aging. The Otago exercise program (OEP) has been widely used to prevent falls for older adults. However, the effects of OEP on physical function remain controversial and the possible effects modifiers have not been assessed. OBJECTIVE: To evaluate the effects of OEP on physical function in older adults and to explore potential moderators underlying the effects of OEP. METHODS: We searched five electronic databases and relevant systematic reviews to identify studies. We included randomized controlled trials (RCTs) evaluating the effects of OEP as a single intervention on physical function among older adults aged 65 and over. Meta-analysis was performed using the random-effects model. Standardized mean differences (SMD) for physical function changes, pertinent to balance, strength, and mobility, were outcome measures. Subgroup analyses on exercise protocol and participants' characteristics were performed. RESULTS: Thirteen RCTs consisting of 2402 participants were included in this systematic review and meta-analysis. Results indicated a significant effect of OEP on balance (SMD = 0.59, 95 % CI: 0.22â¼0.96), lower body strength (SMD = 0.93, 95 % CI: 0.31â¼1.55), and mobility (SMD = -0.59, 95 % CI: -0.95â¼-0.22) against control groups. No significant OEP effects were found on upper body strength (MD = 1.48, 95 % CI: -0.58â¼3.55). Subgroup analysis revealed that the video-supported delivery mode was more effective for improving balance (P = 0.04) and mobility (P = 0.02) than the face-to-face mode. Session durations over 30 min was more effective on lower body strength (P < 0.001) and mobility (P < 0.001) than those 1-30 min. Program period of 13-26 weeks was more effective on mobility (P = 0.02) than those of 4-12 weeks. However, the effects of OEP on physical function were not associated with age groups, and baseline falling risks. CONCLUSION: The OEP could improve physical function including balance, lower body strength, and mobility in older adults. Implementing the OEP in video-supported, more than 30 min per session and 4-12 weeks may be the most appropriate and effective exercise protocol for improving physical function among older adults. More RCTs with rigorous design and larger scale are needed to further assess the effectiveness of diverse OEP protocols and quantify the dose-effect relationship.
Asunto(s)
Accidentes por Caídas , Terapia por Ejercicio , Equilibrio Postural , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Anciano , Equilibrio Postural/fisiología , Accidentes por Caídas/prevención & control , Terapia por Ejercicio/métodos , Fuerza Muscular/fisiología , Ejercicio Físico/fisiología , Masculino , Anciano de 80 o más Años , FemeninoRESUMEN
Aims: To evaluate the effectiveness of a multicomponent exercise intervention and to clarify the underlying mechanisms of the program in community-dwelling older adults with cognitive frailty. Additionally, the perception of participants in the program will be explored. Design: A mixed-methods design, including a randomized controlled trial and an exploratory qualitative study, was used. Methods: Each group consists of 41 participants. The experimental group will undergo a 12-week multicomponent exercise intervention, including warm-up, exergaming aerobic exercise, elastic-band resistance exercise, and cool-down. This intervention was developed based on the Health Belief Model (HBM) and Self-Efficacy Model (SEM). The control group will not receive any intervention. Physical frailty and cognitive function will be considered as primary outcomes. Data will be collected both at baseline and at the end of the intervention period. Fisher's exact test, analysis of covariance, and generalized linear models will be conducted to compare mean changes between the two groups. Additionally, the mediation models will be used to examine whether any intervention effects are mediated through exercise self-efficacy. Discussion: The findings of this study are anticipated to provide valuable insights for healthcare providers, enabling them to learn about effective strategies to enhance exercise adherence and promote improved functionality, independence, and quality of life for older adults with cognitive frailty.Clinical trial registration: [https://clinicaltrials.gov/], identifier [ChiCTR2200058850].
RESUMEN
[This corrects the article DOI: 10.3389/fnagi.2024.1282263.].
RESUMEN
BACKGROUND: The mediating effect of social participation and depressive symptoms on the relationship between hearing impairment and frailty remains unclear. METHODS: A total of 3981 participants from three waves of the China Health and Retirement Longitudinal Study (CHARLS) were included. The outcome was incidental frailty. Hearing impairment, social participation, and depressive symptoms were the main variables. Cox regression models and structural equation models were adopted to examine the relationship between hearing impairment, social participation, depressive symptoms, and the incidence of frailty, with adjustments for demographic characteristics and lifestyle variables at baseline. RESULTS: Hearing impairment (hazard ratio [HR] 1.31, 95% confidence interval [CI] 1.12, 1.74), social participation (HR 0.72, 95% CI 0.55, 0.94), and depressive symptoms (HR 1.78, 95% CI 1.37, 2.30) were associated with the incidence of frailty. Hearing impairment was associated with frailty not only through social participation (ß = 0.015, 95% CI 0.003, 0.037) and depressive symptoms (ß = 0.070, 95% CI 0.037, 0.116) separately but also through social participation and depressive symptoms sequentially (ß = 0.002, 95% CI 0.001, 0.004). Furthermore, the effect of social participation on frailty occurred in participants with hearing impairment, while the effect of depressive symptoms on frailty occurred in participants with normal hearing status. CONCLUSIONS: Hearing impairment is associated with frailty, in which social participation and depressive symptoms partly mediate the association. The effect of social participation and depressive symptoms on frailty varies across hearing statuses. Integrated and comprehensive intervention measures, including hearing screenings, promoting social participation, and improving depressive symptoms, are suggested to prevent frailty.
Asunto(s)
Fragilidad , Pérdida Auditiva , Humanos , Estudios Longitudinales , Participación Social , Depresión/epidemiología , Incidencia , Pérdida Auditiva/epidemiologíaRESUMEN
Background: Several prediction models for cognitive frailty (CF) in older adults have been developed. However, the existing models have varied in predictors and performances, and the methodological quality still needs to be determined. Objectives: We aimed to summarize and critically appraise the reported multivariable prediction models in older adults with CF. Methods: PubMed, Embase, Cochrane Library, Web of Science, Scopus, PsycINFO, CINAHL, China National Knowledge Infrastructure, and Wanfang Databases were searched from the inception to March 1, 2022. Included models were descriptively summarized and critically appraised by the Prediction Model Risk of Bias Assessment Tool (PROBAST). Results: A total of 1,535 articles were screened, of which seven were included in the review, describing the development of eight models. Most models were developed in China (n = 4, 50.0%). The most common predictors were age (n = 8, 100%) and depression (n = 4, 50.0%). Seven models reported discrimination by the C-index or area under the receiver operating curve (AUC) ranging from 0.71 to 0.97, and four models reported the calibration using the Hosmer-Lemeshow test and calibration plot. All models were rated as high risk of bias. Two models were validated externally. Conclusion: There are a few prediction models for CF. As a result of methodological shortcomings, incomplete presentation, and lack of external validation, the models' usefulness still needs to be determined. In the future, models with better prediction performance and methodological quality should be developed and validated externally. Systematic review registration: www.crd.york.ac.uk/prospero, identifier CRD42022323591.
RESUMEN
BACKGROUND: Conventional exercises (CEs) can provide health benefits for older adults, but the long-term exercise adherence rate is low. As an emerging, stimulating, and self-motivating strategy, exergames (EGs) are defined as combinations of exercises and games that users carry out through physical actions. They can promote exercise, but the health effects of EGs versus CEs on the physical function and mental health (cognitive function, depression, and quality of life) of older adults remain controversial. OBJECTIVE: The aim of the study is to compare the health benefits of EGs versus those of CEs for the physical function and mental health of older adults. METHODS: A comprehensive search was conducted from the earliest available date to February 2023 in the following 6 databases: PubMed, Web of Science, Embase, Cochrane, CINAHL, and PsycINFO. All English-language randomized controlled trials comparing the effects of EGs versus those of CEs on the physical function and mental health of older adults, with nearly same physical activity between the 2 interventions, were included. Risk of bias was independently evaluated by 2 authors using the Cochrane risk of bias in randomized trials tool. Two authors independently extracted data. We followed the Cochrane Handbook of Systematic Reviews of Interventions to process and analyze the data for meta-analysis. Standardized mean differences (SMDs) and 95% CIs were used for continuous data, and random models were used for analyses. RESULTS: We included 12 studies consisting of 919 participants in total. Of these, 10 studies were eventually included in the meta-analysis. The results showed that EGs versus CEs exhibited no significant differences in physical (P=.13; τ2=0.31; χ26=26.6; I2=77%; SMD=0.37; 95% CI -0.11 to 0.86) or cognitive function (P=.63; τ2=0.01; χ23=3.1; I2=4%; SMD=0.09; 95% CI -0.27 to 0.44) effects. CONCLUSIONS: Our findings indicate no significant difference between EGs and CEs in improving the physical function and cognitive function of older adults. Future studies are required to compare the effects of EGs versus those of CEs on cognitive function according to cognitive status, quantify the "dose-effect" relationship between EGs and health benefits, and evaluate the effects of different types and devices of EGs with regard to the health benefits of older adults. TRIAL REGISTRATION: PROSPERO CRD42022322734; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=322734.
RESUMEN
Background: Hearing loss can exacerbate cognitive decline; therefore, exploring the mechanisms through which hearing loss affects cognitive function is crucial. The current study aimed to investigate the impact of hearing loss on cognitive function and the mediating role played by self-rated health and depressive anxiety symptoms. Methods: Using stratified whole-group random sampling, the study employed a cross-sectional design and included 624 participants aged ≥65 years from three communities in Urumqi, China. Cognitive function was assessed using the Mini-Mental State Examination. Hearing function and self-rated health were determined by self-report. The 15-item Geriatric Depression Scale and the 7-item Generalized Anxiety Disorder Scale were used to assess depressive anxiety symptoms. Serial mediation analysis was performed using AMOS 26.0. Results: Hearing loss can not only negatively affect cognitive function in older adults directly (direct effect = -0.106; SE = 0.045; 95% confidence interval (CI): -0.201 to -0.016), but also indirectly affect the relationship between hearing loss and cognitive function through self-rated health and depressive anxiety symptoms. The results of the serial mediation analysis showed that the total indirect effect of self-rated health and depressive anxiety symptoms was -0.115 (95% CI: -0.168 to -0.070), and the total effect of the model was -0.221 (95% CI: -0.307 to -0.132), with the total indirect effect accounting for 52.04% of the total effect of the model. Conclusion: Our study discovered that there is a partial mediation of the relationship between hearing loss and cognitive function by self-rated health and depressive anxiety symptoms. It is suggested that by enhancing self-rated health and ensuring good mental health, the decline in cognitive function among older adults with hearing loss can be delayed.