An intervention designed to improve sensory impairments in the elderly and indoor lighting in their homes: an exploratory randomized controlled trial

Abstract

BackgroundVision and hearing impairments in the elderly (aged over 80 years) and poor indoor lighting conditions in a home-care setting are risk factors for functional decline, reduced social participation, withdrawal, and accidents.ObjectiveWe aimed to evaluate the changes in vision, hearing, and lighting conditions in the homes of participants aged over 80 years after implementation of a clinical intervention.MethodsWe undertook an exploratory randomized, controlled experimental study of sensory impairments and lighting conditions in the homes of elderly aged over 80 years who received home care. The intervention group (IG) received advice and encouragement to improve their vision, hearing, and indoor lighting conditions in the home, with a 10-week follow-up period. The control group (CG) received their usual care and underwent the same vision and hearing tests but were provided no intervention.ResultsVision and hearing (self-assessed) and tested by Wilcoxon rank-sum test were significantly better (P=0.025 and P=0.008, respectively) in the IG after the intervention and follow-up. The test between the groups showed a significance of P=0.026 for visual acuity and P=0.098 for pure-tone average. The maximum and minimum lighting levels were significantly improved in the IG after the intervention (P=0.002 and P=0.039, respectively) but were unchanged in the CG.ConclusionSeveral of the IG participants did not follow all of the advice; however, among those who did, vision, hearing, and lighting conditions were all significantly improved. It appears that modest interventions have great potential for improving vision and hearing. Older patients in the home-care setting cannot be expected to take the necessary action to improve their sensory impairments by themselves. They require close monitoring, help from a specialist, and help to improve the indoor lighting conditions in their homes.

Screening for impaired vision in community-dwelling adults aged 65 years and older in primary care settings

“…[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] The RCTs were conducted in Norway, 19 Germany, 20 the United Kingdom, 19 and an insurance company registry. 27 The number of participants in the trials ranged from 93 to 4340.…”

“…In the remaining 4 RCTs, participant eligibility was specified as at least 70 years of age, 23,24 at least 75 years of age, 20 or 74 to 84 years of age. 30 In the 11 RCTs 19,20,22,[25][26][27][28][30][31][32][33] that reported sex, 63% of participants were female.…”

“…In 13 RCTs, [19][20][21][22][23][24][25]27,[29][30][31][32][33] vision screening took place within a broader assessment of multiple health and functional domains, whereas in two RCTs, 26,28 vision screening was the only intervention provided. The two types of screening approaches (used alone or in combination) were self-report of visual function using a questionnaire and objective vision testing using one or more charts.…”

Hearing Impairment in Old Age

“…If they have to spend money to improve their hearing, this might afect their budget, and therefore they may not prioritize it [34]. Thus, recommendations would be to set clear goals and to closely and carefully help the elderly in every way possible to optimize their hearing function until the goals are reached [14].…”

“…Traditionally, hearing impairments have to a large extent been an area for the elderly themselves or their relatives have been responsible for, but it seems that there is a lack of information because many elderly never check their hearing, apply for hearing aids, or seek any other professional help for their hearing impairment [13,14].…”