Abstract
ObjectivesHearing, vision, and cognitive impairment commonly co‐occur in older adults. Improving sensory function may positively impact outcomes in people with dementia (PwD). We developed a “sensory intervention” (SI) to support hearing and vision in PwD. Here, we report the findings of an international open‐label field trial, and nested case series, to explore the impact of the SI on dementia‐related outcomes.MethodsThis was a home‐based trial conducted in France, England, and Cyprus. Participants were people with mild‐to‐moderate dementia and hearing and/or vision impairment (n = 19) and their study partners (unpaid carers; n = 19). The “basic” SI included a hearing and vision assessment and provision of glasses and/or hearing aids. A subsample received the “extended” SI with additional weekly visits from a sensory support therapist (SST). Exploratory analyses of dementia‐related, health utility and resource utilisation outcomes were performed.ResultsQuality of life (QoL) and sensory functional ability improved. Change in QoL exceeded the threshold for a minimum clinically important difference. There was a modest improvement (in absolute terms) post intervention in behavioural disturbance, self‐efficacy, and relationship satisfaction. Study partner time assisting instrumental activities of daily living (iADL) and supervision decreased by about 22 and 38 hours per month, respectively, although time for personal ADL support increased. Qualitative data supported effectiveness of the intervention: PwD were more socially engaged, less isolated, less dependent on study partners, and had improved functional ability and communication.ConclusionsThese findings support the need for a definitive randomised controlled trial (RCT) to evaluate the effectiveness of the intervention.
Highlights
Hearing and vision impairments are more common in people with dementia (PwD) than in those who are cognitively healthy.[1,2] Such impairments negatively affect a range of dementia‐related outcomes, including quality of life (QoL), behaviour, and cognition, as well as imposing an added burden on health, social, and informal care.[3,4,5,6] There is some evidence that correcting vision and hearing impairments with glasses and hearing aids, respectively, may improve outcomes,[7] but in PwD, adherence is often low.[8]
This is the second report of the SENSE‐Cog Field Trial detailing the impact of a home‐based intervention of both hearing and/or vision remediation in people living with dementia and their study partners
We detailed the feasibility of conducting such a study in this population, as well as the acceptability and tolerability of the intervention itself.[12]
Summary
Hearing and vision impairments are more common in people with dementia (PwD) than in those who are cognitively healthy.[1,2] Such impairments negatively affect a range of dementia‐related outcomes, including quality of life (QoL), behaviour, and cognition, as well as imposing an added burden on health, social, and informal care.[3,4,5,6] There is some evidence that correcting vision and hearing impairments with glasses and hearing aids, respectively, may improve outcomes,[7] but in PwD, adherence is often low.[8] correcting the sensory impairment alone may be insufficient and multifaceted interventions, including adherence support and communication training, may be needed. Each component of the SI corresponded with one or more of the COM‐B elements, as outlined in detail previously.[5]
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