First, vision gets weaker. Or maybe hearing is the first go. Loss of these senses as we age can bring with it some risks for mental health as our connection with the world narrows.

While only an estimated 1 in every 1,000 people under the age of 45 has trouble seeing, 1 in every 13 people over the age of 65 does, according to the American Foundation for the Blind. Hearing suffers a similar decline: Among people aged 65 to 74, 23% have trouble hearing; after age 75, the figure climbs to nearly 40%.

In addition to weakening important connections to the environment, this often-gradual onset of sensory deprivation can have other important effects on the brain. It is associated with the development of mood disorders and with declines in key aspects of mental functioning. Finding ways to prevent sensory change, and to adjust to impairments if they develop, is important if we are to maintain mental health as we age, according to Massachusetts General Hospital’s Mind, Mood & Memory Department.

“Vision and hearing loss are major public health issues because they affect so many older individuals and because they have an adverse impact on mental health,” says Dennis Norman, EdD, chief of psychology at Massachusetts General Hospital. “If the senses are limited, everything is affected, including interaction with surroundings, relationships, activities, and feelings of self-worth. Impairment can lead to depression, anxiety, social isolation, and many other problems.”