Older Adults With a Combination of Vision and Hearing Impairment Experience Higher Rates of Cognitive Impairment,Functional Dependence,and Worse Outcomes Across a Set of Quality Indicators
Restricted accessResearch articleFirst published online January, 2019
Older Adults With a Combination of Vision and Hearing Impairment Experience Higher Rates of Cognitive Impairment,Functional Dependence,and Worse Outcomes Across a Set of Quality Indicators
Objectives: Hearing and vision impairment were examined across several health-related outcomes and across a set of quality indicators (QIs) in home care clients with both vision and hearing loss (or dual sensory impairment [DSI]). Method: Data collected using the Resident Assessment Instrument for Home Care (RAI-HC) were analyzed in a sample of older home care clients. The QIs represent the proportion of clients experiencing negative outcomes (e.g., falls, social isolation). Results: The average age of clients was 82.8 years (SD = 7.9), 20.5% had DSI and 8.5% had a diagnosis of Alzheimer’s disease (AD). Clients with DSI were more likely to have a diagnosis of dementia (not AD), have functional impairments, report loneliness, and have higher rates across 20 of the 22 QIs, including communication difficulty and cognitive decline. Clients with highly impaired hearing, and any visual impairment, had the highest QI rates. Discussion: Individuals with DSI experience higher rates of adverse events across many health-related outcomes and QIs. Understanding the unique contribution of hearing and vision in this group can promote optimal quality of care.
BartlettG.BlaisR.TamblynR.ClermontR. J.MacGibbonB. (2008). Impact of patient communication problems on the risk of preventable adverse events in acute care settings. Canadian Medical Association Journal, 178, 1555-1562.
2.
BosJ. T.FrijtersD. H. M.WagnerC.CarpenterG. I.Finne-SoveriH.TopinkovaE.. . . BernabeiR. (2007). Variations in quality of home care between sites across Europe, as measured by home care quality indicators. Aging Clinical and Experimental Research, 19, 323-329.
3.
BrennanM.HorowitzA.SuY. (2005). Dual sensory loss and its impact on everyday competence. Gerontologist, 45, 337-346.
4.
BrennanM.SuY. P.HorowitzA. (2006). Longitudinal associations between dual sensory impairment and everyday competence among older adults. Journal of Rehabilitation Research & Development, 43, 777-792.
5.
BurrowsA. B.MorrisJ. N.SimonS. E.HirdesJ. P.PhillipsC. D. (2000). Development of an MDS-based depression rating scale for use in nursing homes. Age and Ageing, 29, 165-172.
6.
CabanA. J.LeeD. J.Gomez-MarinO.LamB. L.ZhengD. D. (2005). Prevalence of concurrent hearing and visual impairment in US adults: The national health interview survey, 1997-2002. American Journal of Public Health, 95, 1940-1942.
7.
CampbellV.CrewsJ.MoriartyD.ZackM.BlackmanD. (1999). Surveillance for sensory impairment, activity limitation, and health related quality of life among older adults—United States, 1993-1997. MMWR CDC Surveillance Summaries, 48, 131-156.
Capella-McDonnallM. (2009). The effects of developing a dual sensory loss on depression in older adults: A longitudinal study. Journal of Aging and Health, 21, 1179-1199.
12.
ChienW.LinF. R. (2012). Prevalence of hearing aid use among older adults in the United States. Archives of Internal Medicine, 172, 292.
13.
CrewsJ. E.CampbellV. A. (2004). Vision impairment and hearing loss among community-dwelling older Americans: Implications for health and functioning. American Journal of Public Health, 94, 823-829.
14.
DalbyD.HirdesJ. P.StoleeP.StrongJ. G.PossJ.TjamE. Y.. . . AshworthM. (2009). Development and psychometric properties of a standardized assessment for adults who are deaf-blind. Journal of Visual Impairment & Blindness, 103, 1-18.
15.
FratiglioniL.Piallard-BorgS.WinbladB. (2004). An active and socially integrated lifestyle in late life might protect against dementia. Lancet Neurology, 3, 353.
16.
FriesB. E.SimonS. E.MorrisJ. N.FlodstromC.BooksteinF. L. (2001). Pain in US nursing homes: Validating a pain scale for the minimum data set. Gerontologist, 41, 173-179.
17.
GatesG. A.AndersonM. L.McCurryS. M.FeeneyM. P.LarsonE. B. (2011). Central auditory dysfunction as a harbinger of Alzheimer dementia. Archives of Otolaryngology: Head & Neck Surgery, 137, 390-395.
18.
GuthrieD. M.DeclercqA.Finne-SoveriH.FriesB. E.HirdesJ. P. (2016). The health and well-being of older adults with dual sensory impairment (DSI) in four countries. PLoS ONE, 11, e0155073. doi:10.1371/journal.pone.0155073
19.
GuthrieD. M.TheriaultE.DavidsonJ. G. S. (2015). Self-rated health, cognition, and dual sensory impairment are important predictors of depression among home care clients in Ontario. Home Health Care Management & Practice, 28, 35-34.
20.
HaradaS.NishiwakiY.MichikawaT.KikuchiY.IwasawaS.NakanoM.. . . TakebayashiT. (2008). Gender difference in the relationships between vision and hearing impairments and negative well-being. Preventive Medicine, 47, 433-437.
21.
HeineC.BrowningC. J. (2002). Communication and psychosocial consequences of sensory loss in older adults: Overview and rehabilitation directions. Disability and Rehabilitation, 24, 763-773.
22.
HeineC.BrowningC. J. (2004). The communication and psychosocial perceptions of older adults with sensory loss: A qualitative study. Ageing & Society, 24, 113-130.
23.
HeineC.ErberN. P.OsbornR.BrowningC. J. (2002). Communication perceptions of older adults with sensory loss and their communication partners: Implications for intervention. Disability and Rehabilitation, 24, 356-363.
24.
HicksonL.AllenJ.BeswickR.FultonM.WolfD.WorrallL.. . . ScarinciN. (2008). Relationships between hearing disability, quality of life and wellbeing in older community-based Australians. Australian & New Zealand Journal of Audiology, 30, 99-112.
25.
HirdesJ.FrijtersD. H.TeareG. F. (2003). The MDS-CHESS scale: A new measure to predict mortality in institutionalized older people. Journal of the American Geriatrics Society, 51, 96-100.
26.
HirdesJ. P.FriesB. E.MorrisJ. N.IkegamiN.ZimmermanD.DalbyD. M.. . . JonesR. (2004). Home care quality indicators (HCQIs) based on the MDS-HC. Gerontologist, 44, 665-679.
27.
HirdesJ. P.PossJ. W.MitchellL.KorngutL.HeckmanG. (2014). Use of the interRAI CHESS scale to predict mortality among persons with neurological conditions in three care settings. PLoS ONE, 9, e99066. doi:10.1371/journal.pone.0099066
28.
Hjaltado’ttirI.HallbergI. R.EkwallA. K.NybergP. (2011). Predicting mortality of residents at admission to nursing home: A longitudinal cohort study. BMC Health Services Research, 11, 86.
29.
IezzoniL. I.DavisR. B.SoukupJ.O’DayB. (2002). Satisfaction with quality and access to health care among people with disabling conditions. International Journal of Quality in Health Care, 14, 369-381.
30.
IezzoniL. I.DavisR. B.SoukupJ.O’DayB. (2003). Quality dimensions that most concern people with physical and sensory disabilities. Archives of Internal Medicine, 163, 2085-2092.
31.
JonesK.PerlmanC. M.HirdesJ.ScottT. (2010). Screening cognitive performance with the resident assessment instrument for mental health cognitive performance scale. La Revue Canadienne De Physciatrie, 55, 736-740.
32.
KellerB. K.MortonJ. L.ThomasV. S.PotterJ. F. (1999). The effect of visual and hearing impairments on functional status. Journal of the American Geriatrics Society, 47, 1319-1325.
33.
KielyK. M.AnsteyK.LuszczM. A. (2012). Dual sensory loss and depressive symptoms: The importance of hearing, daily functioning, and activity engagement. Frontiers in Human Neuroscience, 7, 1-13.
34.
LandiF.TuaE.OnderG.CarraraB.SgadariA.RinaldiC.. . . BernabeiR. (2000). Minimum data set for home care: A valid instrument to assess frail older people living in the community. Medical Care, 38, 1184-1190.
35.
LawtonM. P.BrodyE. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist, 3, 179-186.
36.
LinF. R.FerrucciL.AnY.DoshiJ.MetterE.DavatzikosC.. . . ResnickS. M. (2014). Association of hearing impairment with brain volume changes in older adults. NeuroImage, 15, 84.
37.
LinF. R.YaffeK.XiaJ.XueQ.HarrisT. B.Purchase-HelznerE.. . . SimonsickE. M. (2013). Hearing loss and cognitive decline among older adults. Journal of American Medical Association, 173, 1-14.
38.
LinM. Y.GutierrezP. R.StoneK. L.YaffeK.EnsrudK. E.FinkH. A.. . . MangioneC. M. (2004). Vision impairment and combined vision and hearing impairment predict cognitive and functional decline in older women. Journal of the American Geriatrics Society, 52, 1996-2002.
39.
MahoneyF. L.BarthelD. A. (1965). Functional evaluation: The Barthel Index. Maryland State Medical Journal, 14, 56-61.
40.
MartinL.PossJ. W.HirdesJ. P.JonesR. N.StonesM. J.FriesB. E. (2008). Predictors of a new depression diagnosis among older adults admitted to complex continuing care: Implications for the Depression Rating Scale (DRS). Age and Ageing, 37, 51-56.
41.
McDonnallM. C. (2009). Risk factors for depression among older adults with dual sensory loss. Aging & Mental Health, 13, 569-576.
42.
The Ministry of Health and Long-Term Care. (2006). Community care access centres: Client services policy manual. Ottawa, Ontario, Canada: Author.
43.
MorV.IntratorO.UnruhM.CaiS. (2011). Temporal and geographic variation in the validity and internal consistency of the nursing home Resident Assessment Minimum Data Set 2.0. BMC Health Services Research, 11, 78.
44.
MorrisJ. N.BernabeiR.IkegamiN.GilgenR.FrijtersD.HirdesJ. P.. . . HenrardJ. (1999). RAI-Home Care (RAI-HC) assessment manual for Version 2.0. Washington, DC: interRAI Corporation.
45.
MorrisJ. N.FriesB. E.MehrD. R.HawesC.MorV.LipsitzL. (1994). MDS Cognitive Performance Scale. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 49, M174-M182.
46.
MorrisJ. N.FriesB. E.MorrisS. A. (1999). Scaling ADLs within the MDS. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 54, M546-M553.
47.
MorrisJ. N.FriesB. E.SteelK.IkegamiN.BernabeiR.CarpenterI.. . . TopinkováE. (1997). Comprehensive clinical assessment in community setting: Applicability of the MDS-HC. Journal of the American Geriatrics Society, 45, 1017-1024.
48.
MorrisJ. N.JonesR. N.FriesB. E.HirdesJ. P. (2004). Convergent validity of minimum data set–based performance quality indicators in postacute care settings. American Journal of Medical Quality, 19, 242-247.
49.
Ontario Ministry of Health and Long-Term Care. (2007). Community care access centres: Client services policy manual. Toronto, Ontario, Canada: Author.
50.
PopeS. K.SowersM. (2000). Functional status and hearing impairments in women at midlife. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 55, S190-11S4.
PutsM. T.DeegD. J.HoeymansN.NusselderW. J.SchellevisF. G. (2008). Changes in the prevalence of chronic disease and the association with disability in the older Dutch population between 1987 and 2001. Age and Ageing, 37, 187-193.
53.
ReubenD. B.MuiS.DamesynM.MooreA. A.GreendaleG. A. (1999). The prognostic value of sensory impairment in older persons. Journal of the American Geriatrics Society, 47, 930-935.
54.
SchneiderJ.GopinathB.McMahonC.LeederS.MitchellP.WangJ. (2011). Dual sensory impairment in older age. Journal of Aging and Health, 23, 1309-1324.
55.
SmithS. L.BennettL. W.WilsonR. H. (2008). Prevalence and characteristics of dual sensory impairment (hearing and vision) in a veteran population. Journal of Rehabilitation Research & Development, 45, 597-610.
StoleeP.PossJ.CookR. J.ByrneK.HirdesJ. P. (2009). Risk factors for hip fracture in older home care clients. Journal of Gerontology. Series A, Biological Sciences and Medical Sciences, 64, 403-410.
58.
TayT.WangJ. J.KifleyA.LindleyR.NewallP.MitchellP. (2006). Sensory and cognitive association in older persons: Findings from an older Australian population. Gerontology, 52, 386-394.
59.
von ElmE.EggerM.AltmanD. G.PocockS. J.GotzscheP. C.VandenbrouckeJ. P. (2007). Strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. British Medical Journal, 335, 806-808.
60.
ZhangJ.YuK. (1998). What’s the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. Journal of American Medical Association, 280, 1690-1691.
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