The use of cognitive measures in older adults with concurrent hearing and vision impairment: A scoping review

Abstract

AbstractBackgroundOlder adults with dual sensory impairment (DSI/combined hearing and visual impairment), are more likely to obtain poorer scores on cognitive tests. Whether these results are due to poor cognitive function or inappropriate or absent adaptation of test administration for sensory impaired older adults is unclear. Given that this population is at higher risk of developing dementia, e.g., due to Alzheimer’s disease, ensuring optimal test administration is imperative to provide adequate cognitive care. Therefore, we mapped the existing scientific literature on various cognitive measures/tools that have been used to screen or assess cognitive impairment in older adults with DSI.MethodA scoping review was conducted using the Arksey and O’Malley framework (2005). Scientific articles were searched across eleven databases (CINAHL, Embase, Global Health, Mednar, OAIster, OpenGrey, PsycEXTRA, PsycINFO, PubMed, Web of Science, and WorldWideScience). The inclusion criteria were: the articles considered and/or measured cognitive function, in individuals with DSI, aged 65 and older. Extracted data included sample cognitive status, cognitive measure type (objective or subjective), reported cognitive domains evaluated by the measure, psychometric properties as well as reported, if any, sensibility measures during administration.ResultOf 11,595 articles retrieved, fifty‐six (n = 56) met the inclusion criteria. All but five (n=5) studies employed an objective measure of cognitive function. The most commonly used cognitive test in studies with older adults with DSI is the Mini‐Mental State Examination (1975) with almost 1/3 of the studies reporting its use (n=17). More importantly, none of the studies in this scoping review used cognitive tests that were adapted for vision and hearing impairment, highlighting that optimal cognitive assessment in DSI is neglected.ConclusionMost objective cognitive tests include vision‐ and hearing‐dependent items and require functional vision and/or hearing for both the administration and the execution of these tests. Our study confirmed the use of commonly used standardized tests, initially validated in a healthy population, to measure the cognitive function of older adults with DSI. Identifying these generally utilized tools is the first step to developing optimal adaptations in their administration for this vulnerable population.