Abstract
This study’s main objective was to assess the sensitivity and specificity of the interRAI Community Health Assessment (CHA) for detecting the presence of vision loss (VL), hearing loss (HL) or both (Dual Sensory Loss, DSL) when compared against performance-based measures of vision and hearing. The interRAI CHA and the Montreal Cognitive Assessment (MoCA) were administered to 200 adults (61+ years of age) who had VL, HL or DSL. We calculated the sensitivity and specificity of the interRAI CHA for detecting sensory impairments using as the gold standard performance based measurements of hearing (pure-tone audiogram) and vision (distance acuity) as determined from the rehabilitation centre record. Results were divided according to participants’ cognitive status, as measured by the MoCA and the Cognitive Performance Scale (CPS, embedded within the interRAI CHA). Overall, sensitivity was 100% for VL, 97.1% for HL, and 96.9% for DSL. Specificity was at least 93% in all three groups. In participants who failed the MoCA (i.e., at risk of mild cognitive impairment), the sensitivity was 100% for VL, 96.8% for HL and 96.2% for DSL; in those who were not at risk, the sensitivity was 100% for VL, and 97.4% for HL and DSL. In participants classified by the CPS as borderline intact or mild cognitively impaired, sensitivity was 100% in all groups; in those classified as cognitively intact, sensitivity was 100% for VL, 97.0% for HL, and 96.8% for DSL. These results suggest that the interRAI CHA detects VL, HL, and DSL in high agreement with performance-based measurements of vision and hearing. The interRAI CHA shows high accuracy even in participants with mild cognitive difficulties. Since results were found in a specific population of older rehabilitation clients who all had sensory difficulties, further research is needed to understand its role in screening in other more diverse groups.
Highlights
Dual sensory loss (DSL) refers to the combination of concurrent vision and hearing loss irrespective of age or the order of onset of the sensory losses [1]
Because older adults with sensory loss may have cognitive impairment, which may limit the accuracy of the screening tool in identifying DSL, this study reports sensitivity and specificity results for sub-groups of participants categorized as having normal cognition or not based on two cognitive screening measures, the Montreal Cognitive Assessment (MoCA) and Cognitive Performance Scale (CPS)
Because higher CPS scores indicate worse cognitive functioning whereas higher MoCA scores indicate better cognitive functioning, this correlation indicates that the CPS and the MoCA scores vary in the same direction
Summary
Dual sensory loss (DSL) refers to the combination of concurrent vision and hearing loss irrespective of age or the order of onset of the sensory losses [1]. DSL constitutes a unique disability in which a person may not be able to compensate for the loss in one of these two senses by using the other sense [2,3]. Persons with DSL are at greater risk for many health issues (e.g., impaired mobility, depression) [5], and compared to persons with other disabilities, are more likely to have a low socio-economic status, and have poorer educational outcomes [6]. The incidence of DSL is higher in older adults (65+ years of age) with prevalence estimates varying across studies depending on their methodologies and the sub-groups of older adults included in their samples. Across four countries (Canada, US, Finland and Belgium), the prevalence of DSL in older adults ranges between 9.7% and 33.9% in long-term care facilities, and between 13.4% and 24.6% in home care [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
