Dual Sensory Loss Research Articles

Association of Spouses’ Sensory Loss with Depressive Symptoms, Self-Reported Health, and Functional Disability Among Middle-Aged and Older Adults in China: A Cross-Sectional Study

ABSTRACT Objective To investigate cross-sectional associations between spouses’ sensory loss and depressive symptoms, self-rated health, and functional disability. Methods We included 10,410 individuals from the China Health and Retirement Longitudinal Study. We used the cross-sectional design and determined hearing loss, vision loss, and dual sensory loss by self-reports. We assessed depressive symptoms using the Center for Epidemiological Studies Depression Scale. We assessed self-reported health status using one item. Functional disability was defined as having difficulties in activities of daily living (ADL) and instrumental activities of daily living (IADL). Results Individuals with spouses’ dual sensory loss had a higher prevalence of depressive symptoms (45.19%), ADL (17.31%), and IADL impairments (21.97%) and a lower rate of self-rated good health (20.78%) than those with no or single loss. Spouse’s sensory loss was associated with depressive symptoms, self-rated health, ADL, and IADL impairments (p < .05). Husbands’ ADL impairments were associated with wives’ vision loss (p < .05). Wives’ IADL impairments were associated with husbands’ hearing loss (p < .05). Conclusions Spouses’ sensory loss was related to depressive symptoms, self-rated health, ADL, and IADL impairments. There was a gender specificity in the effect of spousal vision loss or hearing loss on ADL and IADL impairments.

Identifying Dual Sensory Loss Among Students With Extensive Support Needs

Identifying Dual Sensory Loss Among Students With Extensive Support Needs

Visualizing Worldwide Prevalence of Age-Related Dual Sensory Loss.

Objectives: This study aims to create a first visualization of global prevalence of age-related dual sensory loss (DSL), significantly affecting older people's quality of life. Methods: Data from World Health Organization (WHO) regions, particularly African, American, and European, were analyzed. The study focused on DSL onset and prevalence, using adjusted life expectancy for regional comparison. Results: There were notable regional variations in DSL onset and prevalence. The African region showed consistent data, thanks to standardized methods from the World Federation of the Deafblind. However, global patterns varied when adjusted for life expectancy, hinting at possible DSL prevalence stabilization at older ages. Discussion: The study identifies a lack of standardization in DSL prevalence research regarding definitions, methodologies, and reporting. It calls for more uniform and thorough research methods for accurate global DSL understanding. The research highlights the complexity and challenges in determining DSL prevalence worldwide.

The association between dual sensory loss and healthcare expenditure: Mediating effect of depression

BackgroundPrevious studies have suggested the dual sensory loss (DSL) is linked to depression, and that they are associated with higher healthcare expenditures, respectively. However, the association between DSL, depression and healthcare expenditures remains ambiguous. ObjectivesThe current study aims to examine the association between DSL, depression and healthcare expenditures as well as catastrophic health expenditures (CHE) among Chinese people aged 45 and above. MethodsWe first utilized the China Health and Retirement Longitudinal Survey (CHARLS) 2018 to obtain data from a total of 13,412 Chinese individuals aged 45 and above to conduct a cross-sectional study. DSL was defined as a combined variable of self-reported vision loss and hearing loss. Depression was measured using The Center for Epidemiologic Studies Depression Scale (CESD-10). The healthcare expenditures, including outpatient out-of-pocket cost and inpatient out-of-pocket cost, were obtained from the Harmonized CHARLS section. CHE were defined as out-of-pocket (OOP) health spending equal to or higher than 40 % of a household's capacity to pay. A Tobit linear regression with three models and a path analysis were conducted to estimate the association between DSL, depression and healthcare expenditures and CHE. Then we utilized 2011CHARLS and 2018CHARLS to present a longitudinal analysis. A path analysis was conducted to estimate the association between 2011DSL, 2018depression and 2018healthcare expenditures and CHE. ResultsDepression has a significant mediating effect between DSL and healthcare expenditures. (For outpatient OOP cost: a = 0.453, b = 23.559, c = 25.257, the proportion of mediating effect in total effect = 29.71 %; for inpatient OOP cost: a = 0.453, b = 13.606, c = 15.463, the proportion of mediating effect in total effect = 28.50 %; all P < 0.05). The mediating effect of depression also exists in the association between DSL and CHE (a = 0.453, b = 0.018, c = 0.043, the proportion of mediating effect in total effect = 15.90 %; P < 0.05). The mediation effect of depression on healthcare expenditures and CHE also exists in the longitudinal analysis using CHARLS 2011 and CHARLS 2018 (all P < 0.05). LimitationsThe DSL status were based on self-report and we used 2018CHARLS to conduct the study, which may cause some bias. ConclusionSignificant mediating effect of depression exists between DSL and higher healthcare expenditures and CHE. The mental health of elder people with DSL should be focused on, and we should have an overall viewpoint on the topic of healthcare expenditures and CHE.

DUAL SENSORY LOSS AND COGNITIVE TEST PERFORMANCE IN OLDER ADULTS IN INDIA

Abstract Dementia is rising in the global population, especially in low- and middle-income countries like India. Hearing and vision loss are risk factors for cognitive decline/dementia, but studies have primarily been in high income countries. This study aims to investigate the association between dual sensory loss and cognitive function with specific domains among the older Indian population. Data was from the 2017-2019 Wave 1 of the population-based Longitudinal Aging Study in India. The analysis sample consists of 27,975 individuals aged 60 years and older in 35 states and union territories. Dual sensory loss was determined by respondents’ self-reported, perceived difficulty regarding hearing and vision function. Linear regression was used to model associations of dual sensory loss with global cognitive performance, summarized as a z-score, and in the domains of memory, orientation, arithmetic, and executive function, adjusted for demographics and health characteristics. Overall, 5.9% had hearing loss, 24.1% had vision loss, and 3.4% had both. In fully adjusted models, hearing loss only, vision loss only, and dual sensory loss were associated with a change of -0.08 (95%CI: -0.1, -0.04), -0.11 (95%CI: -0.12, -0.09), and -0.22 (95%CI: -0.27, -0.18) standard deviations, respectively. Associations were also observed for all domains. Poor hearing and/or vision loss is associated with lower cognitive performance across various cognitive domains in older adults in India. The association was strongest for those with dual sensory loss. Rehabilitative interventions for hearing and vision may be an additional resource in reducing dementia risk in India.

HEARING AND VISION LOSS: EPIDEMIOLOGIC AND INTERVENTION IMPLICATIONS FOR SOCIAL ISOLATION, LONELINESS, AND MOOD DISORDERS

Abstract This session will discuss hearing loss and vision impairment as modifiable risk factors for social isolation, loneliness, and mood disorders from both epidemiologic and intervention perspectives. Prevalence of hearing and vision loss is high; two-thirds of older adults have hearing loss and over one-quarter have vision impairment. Hearing loss and vision impairment have been linked to poor cognitive and physical health but remain understudied in the context of social and mental health in large, population-based studies. Research gaps remain in measurement (findings typically based on subjective assessments) and generalizability. This session will investigate associations between objectively measured hearing, vision, and dual sensory loss on social isolation and mood disorders using a sample nationally representative of older adults in the US. This session will also describe potential mechanistic and environmental factors, such as fatigue and exclusion of hearing loss and vision impairment in health care settings that may explain observed associations. Whether treatment of hearing loss and vision impairment is an effective intervention for improving social and mental health is unknown. We will conclude by presenting findings from a randomized controlled trial designed to test whether a hearing intervention consisting of provision of hearing aids and related technologies, counseling, and education could reduce cognitive decline in older adults with untreated hearing loss. We focus on the effect of hearing intervention on social isolation and loneliness, both pre-specified outcomes of this trial. This is a Loneliness and Social Isolation Interest Group Sponsored Symposium. This is a collaborative symposium between the Loneliness and Social Isolation and Sensory Health Interest Groups.

Associations between Sensory Loss and Depressive Symptoms in a Longitudinal National Study of Ageing Adults in Thailand

Introduction: Sensory loss and depressive symptoms (DS) may be an increasing concern in ageing adults. Some previous studies in China found bidirectional associations between sensory loss and DS, but we lack information on this relationship in Southeast Asia. The purpose of this study was to assess the bidirectional association between sensory loss and DS in a longitudinal study in Thailand.&#x0D; &#x0D; Methods: The responses of participants (≥ 45 years) of two consecutive waves (2015 and 2017) of the Health, Aging and Retirement in Thailand (HART) study were analysed. Sensory loss was assessed with self-reported questions and DS with the Center for Epidemiological Studies Depression scale.&#x0D; &#x0D; Results: The analytic baseline sample included 3708 participants (median = 66 years) who responded to the 2015 and 2017 survey. The prevalence of vision, hearing and dual sensory loss were 25.4%, 13.3% and 7.9%, respectively, and the prevalence of DS was 12.3%. In the final model, adjusted for relevant confounders, vision, hearing, and sensory loss at baseline were positively associated with incident DS (AOR: 1.34, 95% CI: 1.01 to 1.74; AOR: 1.71, 95% CI: 1.23 to 2.38; and AOR: 1.80, 95% CI: 1.20 to 2.69, respectively). DS at baseline was not significantly associated with incident vision, hearing or dual sensory loss.&#x0D; &#x0D; Conclusion: Baseline vision, hearing, and dual sensory loss increase the odds of incident DS, but baseline DS did not significantly increase the odds of incident vision, hearing, or dual sensory loss among ageing adults in Thailand.

Impact of Single Compared to Dual Sensory Loss in People with Dementia on Care Partner Outcomes

AbstractBackgroundBoth hearing and vision loss impact significantly on outcomes in people with dementia as well as their care partners. The study aimed to compare the impact on care partner outcomes of hearing loss alone and dual sensory (both hearing and vision) loss in people with dementiaMethodsThe study sample includes data from the SENSE‐Cog Trial (www.sense‐cog.eu). Care partner psychological distress was ascertained using the 12‐item General Health Questionnaire and the Hospital Anxiety and Depression Scale. Caregiving intensity was assessed using the care partner items of the RUD Lite. Dementia symptoms were assessed with the MOCA, the 12‐item Neuropsychiatric Inventory and the Bristol Activities of Daily Living scale. Vision loss was defined by the presence of binocular visual acuity of not more than 6/9.5 and greater than 6/60 in Snellen metric using the Portable Eye Examination Kit (PEEK) vision tool and visual field greater than 10° using confrontation visual field test. Hearing loss was defined by a bilateral hearing difficulty, indicated by failure of a pure tone hearing screening test in both ears. Statistical analyses included comparison between groups with different sensory losses (hearing‐ vs. dual loss) and regression analyses.ResultsData of dyads of people with dementia and either hearing loss (N = 150) or dual sensory loss (N = 92) and their care partners (female 72.5%; male 27.5%) were considered. Participants had Alzheimer’s dementia (65%), vascular dementia (16%) or mixed dementia (19%), with mean MOCA score 16.6 (range 10 – 28). 73% of patients lived with partner or family and 24% alone. Higher caregiving intensity and higher psychological distress were observed in care partners of patients with dual sensory loss compared to care partners of people with hearing loss only after controlling for the impact of cognitive deficits, neuropsychiatric symptoms, performance on activities of daily living and demographic characteristics.ConclusionsDual sensory loss in people with dementia increases care partner distress and caregiving intensity compared to single hearing loss. Shedding light on sensory loss in dementia may pave new ways towards more effective symptom management and higher quality of life of both patients and their care partners.

Population prevalence of dual sensory loss in community-dwelling US adults 71 years and older: Evidence from the National Health and Aging Trends Study.

Existing estimates for the prevalence of dual sensory loss (vision and hearing) among older adults are either based on self-reported measures or aggregated for older age groups. Current and detailed estimates based on objective measures are needed for public health, clinical, and policy decision-making. We estimated the prevalence of dual sensory loss (DSL) using National Health Aging Trends Study (NHATS) Round 11 data (2021). We restricted to community-dwelling adults aged ≥71 years with complete sensory testing data (N = 2579). Hearing loss was defined by a 4-frequency (0.5, 1, 2 and 4 kHz) pure tone average for the better-hearing ear (>25 decibel hearing level). Vision loss was defined by the presence of distance, near (logarithm of the minimum angle of resolution >0.30), or contrast sensitivity loss (log contrast sensitivity <1.55). Participants were categorized into three groups: no sensory loss, single sensory loss (vision or hearing loss), and DSL (hearing and vision). Sensory loss prevalence was estimated by age group and sociodemographic characteristics. In weighted analyses, among older Medicare beneficiaries (53% female, 7% Black, 6% Hispanic), 28% had no sensory loss and 22% had DSL. Prevalence of DSL increased with age. Most adults aged ≥90 years experienced DSL (59%), as opposed to single (39%) or no sensory loss (2%). DSL prevalence was greater among older adults with low education attainment (34%) and household income (43%). A higher proportion of older adults with a college education (17%), or from wealthier households (16%), had no sensory loss. One in 5 community-dwelling Medicare beneficiaries aged ≥71 years have DSL, increasing to 3 in 5 for those aged ≥90 years. Prevalence is higher among older adults with low education attainment and from low-income households, characteristics associated with low treatment. Policies increasing access and affordability of vision and hearing care could benefit millions of older Americans experiencing sensory loss.

Experiences of people with dual sensory loss in various areas of life: A qualitative study.

Individuals with dual sensory loss (DSL) appear to have limited ability to compensate for their visual impairment with residual hearing, or for their hearing impairment with residual vision, resulting in challenges in various areas of life. The aim of this qualitative study was to explore the diverse experiences facing individuals with DSL as well as to determine how they experience sensory compensation. Semi-structured interviews were carried out in twenty adults with DSL (13 females and 7 males, mean age 47 years). The causes of DSL severity varied amongst participants. Sensory compensation and experiences in regards to access to information, mobility, communication and fatigue were discussed. Interviews were audio recorded and transcribed verbatim. Framework analysis was used to summarize and interpret the data. In relation to access to information, our results show that, despite various challenges, the use of assistive technology such as voice command functions, enabled participants to operate effectively. Regarding mobility, most participants were capable of finding their way in familiar environments. However, if the setting was unfamiliar, assistance from others or reliance on navigation applications was necessary. Participants experienced little issues with having conversations in quiet settings, however, crowded settings were considered very difficult. The final results showed that most participants suffered from fatigue. Carefully considering which daily activities were feasible and having a daily routine helped to cope with fatigue. This study revealed the experiences of individuals with DSL in important areas of life. The results suggest that, even though many challenges are experienced, individuals with DSL are resourceful in finding compensation strategies. However, capturing participants' sensory compensation experiences was challenging.

Potentially Preventable Hospitalization Among Adults with Hearing, Vision, and Dual Sensory Loss: A Case and Control Study

ObjectiveTo evaluate the risk of potentially preventable hospitalizations (PPHs) among adults with sensory loss. We hypothesized a greater PPH risk among people with a sensory loss (hearing, vision, and dual) compared with controls. Patients and MethodsUsing 2007-2016 Medicare fee-for-service claims, this retrospective, case-control study examined the risk of PPH among adults aged 65 years and older with hearing, vision, and dual sensory loss compared with their corresponding counterparts without sensory loss (between June 1, 2022, and February 1, 2023). We ran 3 step-in regression models for the 3 case and control cohorts examining PPH risk. Our generalized linear regression models controlled for age, sex, race, Elixhauser comorbidity count, rurality, neighborhood characteristics, and the number of primary care physicians and hospitals at the county level. ResultsPeople with vision (adjusted odds ratio [aOR], 1.21; 95% CI, 0.84-0.87) and dual sensory loss (aOR, 1.26; 95% CI, 1.14-1.40) showed a higher PPH risks than their corresponding controls. For people with hearing loss, our unadjusted models showed a higher PPH risk (OR, 1.40; 95% CI, 1.38-1.43) but after adjustment, hearing loss showed a protective association against PPH risk (OR, 0.85; 95% CI, 0.84-0.87). Moreover, in all models, annual wellness visits reduced the PPH risk by about half (eg, aOR, 0.54; 95% CI, 0.52-0.55), whereas living in disadvantaged neighborhood increased the PPH risk (eg, aOR, 1.13; 95% CI, 1.10-1.15) for cases and controls. ConclusionPeople with vision and dual sensory loss were at greater PPH risk. This study has important health policy implications in reducing PPH and is indicative of a need for more incentivized and systematic approaches to facilitating the use of preventive care, particularly among older adults living in a disadvantaged neighborhood.

Combined severe-to-profound hearing and vision impairment-Experiences of daily life and need of support, an interview study.

The purpose of the present study was to describe experiences of disabilities and factors affecting daily life from the perspective of adult persons with severe-to-profound hearing impairment in combination with severe vision impairment. Furthermore, the study also investigated which kind of support individuals with dual sensory loss received, and their experiences as citizens in the society. Semi-structured qualitative interviews were performed, analyzed, and categorized using content analysis. Fourteen interviews were performed, with equal number of both sexes. Mean age was 70.1 years (47-81 years). Analysis of the data resulted in 22 categories, six sub-themes and two main themes. Two main themes emerged as Isolation and The Ability to control one's own daily life. Surprisingly, most of the participants did not think of their vision and hearing impairment as a combined disability. The interviews showed various kind of strategies to handle daily life. The Deafblind-team unit was reported to offer excellent health care. Companion services for persons with disabilities proved to have become more difficult to get support from and created lack of independence and control over their own lives. However, it was also obvious that the participants felt a positive outlook on life and were more solution-oriented in order to adjust their everyday life to their life-situation. The combination of vision and hearing impairment demonstrated isolation, and the respondents in the study have a need of support in everyday lives. At the same time, they struggle to have the ability to control their own lives.

Advancing an ethical imperative for collaborative approaches to evaluation with low incidence and underserved communities: Insights from a DeafBlind Support Services pilot program evaluation

This practice article advances an ethical imperative for guiding collaborative approaches to evaluation with low incidence and underserved communities. We describe our evaluation processes for building transformative partnerships during a DeafBlind Support Services pilot program evaluation in Western Canada using collaborative approaches to evaluation. This program was designed to enable adults living with dual sensory loss to experience self-determined activities in the community that enhance resilience and belonging. Key features involve specialised Support Service Providers who assist DeafBlind community members with accessing and participating in essential community services and social, vocational, educational, and recreational activities. In presenting our co-generated evaluation insights, we advance an ethical imperative describing philosophical foundations, pragmatic actions, and political leadership for implementation of collaborative approaches to evaluation with a low incidence and underserved community.

Hospitalizations, Emergency Department Visits, and Home Health Use Among Older Adults With Sensory Loss.

Objectives: This study examines healthcare resource use (hospitalizations, emergency department [ED] visits, and home health episodes) among adults 65 and older diagnosed with hearing, vision, or dual sensory loss (SL) seen in the primary care setting of an academic health system. Methods: Multivariable logistic regression models were used to examine the relationship between SL (identified using ICD-10 codes) and healthcare resource use for 45,000 primary care patients. Results: The sample included 5.5% (N = 2479) with hearing loss, 10.4% (N = 4697) with vision loss, and 1.0% with dual SL (N = 469). Hearing loss increased the likelihood of having an ED visit (OR = 1.22, CI: 1.07-1.39), and home health services (OR = 1.27, CI: 1.07-1.51) compared to older adults without any SL. Vision loss reduced the likelihood of having a hospitalization (OR = .81, CI: .73-.91). Discussion: Findings support research into the drivers of healthcare use among older adults with sensory loss.

Sensory Loss and its Association with Different Types of Departures from the Labor Force Among Older Adults in the US.

To investigate the association between sensory loss and the timing and type of self-reported departures from the labor force, via retirement or disability, we used data from the Health and Retirement Study, cycles 2004-2018. Based on self-reported sensory loss, we classified individuals into four groups: no sensory loss, hearing loss only, vision loss only, and dual sensory loss (vision and hearing loss). We assumed that older adults could leave the labor force either by retirement or due to disability. Because once one type of exit is observed the other type cannot be observed, we implemented a competing risk approach to estimate the instantaneous rate of departure (sub-distribution hazard rate) for leaving the labor force due to disability, treating retirement as a competing risk, and for departures via retirement, with disability as the competing risk. We found that compared to older adults with no sensory loss, adults with vision loss are at a higher risk for leaving the labor force via disability (when treating retirement as a competing risk). Compared to no sensory loss, hearing loss was associated with a higher risk for retirement in models treating disability as a competing risk. Given the differences between disability and retirement benefits (before and after retirement age), policies intended to keep people with sensory loss from early labor force departures, such as accommodations in the workplace and/or hearing and vision care coverage, might contribute to better retiring conditions and healthy aging among older adults with sensory loss.

Towards a World Wide Model for the Prevalence of Age-related Dual Sensory Loss (DSL)

Towards a World Wide Model for the Prevalence of Age-related Dual Sensory Loss (DSL)

Acquired Combined Vision and Hearing Loss: Awareness and Perceptions of Australian Aged Care Workers

Introduction: Understanding the attitudes, competency, and awareness of those supporting older people who have an acquired combined vision and hearing loss is an important endeavor for this population. It can help guide aged care policy makers, leaders, and managers in the allocation of resources and training. This Australian study investigated the awareness and perceptions of aged care workers on supporting older adults with acquired combined vision and hearing loss. Methods: Twenty-four participants who were employed in aged care services participated in semistructured interviews that were thematically analyzed. The interviews explored the participants’ awareness of this disability, identification within their service, adaptation strategies, and their access to relevant information. Results: Several themes emerged, including lack of identification and recording of acquired combined vision and hearing loss in this population, lack of awareness of this disability, and lack of available information or training to support aged care workers within their care setting. Discussion: Aged care workers have little understanding of the prevalence of acquired combined vision and hearing loss in an older population. Care plans are key documents for individuals, which outline their needs and any sensory losses; however, this information is not well recorded. Aged care workers have little awareness of how to effectively support this population. When encountering an individual with an acquired combined vision and hearing loss, however, an aged care worker will develop strategies to support the individual. Individuals with this acquired dual-sensory loss, as well as dementia, pose a significant challenge to aged care workers, and dementia is often the primary focus of intervention. Implications for Practitioners: It appears that older individuals living in aged care settings who have acquired combined vision and hearing loss are not adequately identified, nor are aged care workers adequately trained to support individuals with this unique disability.

OLDER ADULTS LEAVING THE WORKFORCE: SENSORY LOSS, RETIREMENT, AND DISABILITY

Abstract Hearing loss (HL), vision loss (VL), and their combination (dual sensory loss, DSL) are common among older adults. Sensory loss impacts labor productivity which might result in departures from the workforce. Whether older adults leave due to retirement or a disability, and how these responses are associated with sensory loss remains unexplored. Using the 2004-2018 rounds of the Health and Retirement Study, self-reported sensory loss (No Impairment/HL/VL/DSL) at baseline, and reason for leaving the workforce (retirement or disability) were observed. Competing risk models models for departures from the workforce treating retirement or disability as a competing risk were estimated. Among 5,201 adults employed at baseline, ages 50-94, 3,436 reported retirement, and 4254 reported a disability as a reason for not working. In Fine-Gray models, treating retirement as a competing risk and adjusting for sociodemographic and clinical characteristics, we found that compared to older adults without impairments, DSL was associated with a 50% increase in the rate of departures from the labor force due to disability among adults in the in the risk group (SHR=1.51; 95% CI=1.09,2.11). In contrast, when treating disability as the competing risk, HL was associated with a 22% increase in the rate of departures labor force due to retirement (SHR=1.22; 95% CI=1.10,1.36) among adults in the risk group when compared to those without impairments. In sample of older adults, we provide evidence that the presence of sensory impairments is associated with departures from the workforce. Our results highlight differences in the type of departures by sensory loss.

DUAL SENSORY LOSS AND DEPRESSIVE SYMPTOMS: FINDINGS FROM THE LONGITUDINAL AGING STUDY IN INDIA (LASI)

Abstract Prior work suggests that vision and hearing loss may be risk factors for depressive symptoms in older adults. However, few studies have focused on the relationship of both vision and hearing loss (dual sensory loss, DSL) and depressive symptoms. Using the first nationally representative population study from LASI in India conducted from 2017-2019, Poisson models tested the association of DSL with depressive symptoms. Self-reported vision and hearing loss were associated with increased depressive symptoms (PR 1.29; 95%CI, 1.25-1.33 and 1.15; 95%CI, 1.09-1.22) after adjusting for age, sex, education, economic status, marital status, urbanicity, region, diabetes, heart disease, hypertension, stroke, and smoking. DSL had a 46% higher risk (95% CI, 1.37-1.56) of depressive symptoms. Poor vision and/or hearing loss may be a risk factor for depressive symptoms in adults in India aged ≥45 years. The risk of depressive symptoms in those with sensory loss should be investigated in further studies.

Continuum of Care for Older Adults With Concurrent Hearing and Vision Impairment: A Systematic Review.

A global report estimates up to 2% of the world population experience concurrent hearing and vision impairment (dual sensory impairment [DSI]). Older adults with DSI are often frequent users of health care, yet the evidence is limited to inform care delivery for this population. This systematic review aimed to synthesize evidence on tools and strategies for screening, assessment, and interventions that promote a continuum of care for older adults with DSI. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews. Electronic databases (CINAHL, Embase, MEDLINE, PsycINFO, Cochrane Library, Global Health, and Web of Science) and clinical trial registries (ISRCTN Registry, WHO ICTRP, and ClinicalTrials.gov) were searched. The quality appraisal was performed using the Mixed Methods Appraisal Tool. Of 4,775 identified references, 28 records were selected. The review identified 7 tools and 7 strategies for DSI-specific screening, assessments, and/or interventions. Some of the most promising tools were the interRAI Community Health Assessment with deafblind supplement, adapted Montreal Cognitive Assessment, and the Severe Dual Sensory Loss screening tool. Useful strategies included the use of alternative forms of communication, assistive devices or technology, education and training for service providers, and training of older adults on the use and maintenance of assistive aids/technology. However, quality appraisal indicated a need for more robust evidence to inform clinical practice. Reviewed evidence pinpointed the need for training for health care providers on DSI-specific challenges and supports and the use of integrated multidisciplinary care for older adults. Future studies need to explore the development and evaluation of tools and interventions to improve the continuum of care for this group. Systematic Review Registration: PROSPERO registration # CRD42020180545.