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

Abstract

Background and Objectives 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 healthcare, 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. Research Design and Methods 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. Results Of 4775 identified references, 28 records were selected. The review identified seven tools and seven strategies for DSI-specific screening, assessments and/or interventions. Some of the most promising tools were the interRAI Community Health Assessment (CHA) with deafblind supplement, adapted Montreal Cognitive Assessment (MoCA) and Severe Dual Sensory Loss (SDSL) 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. Discussion and Implications Reviewed evidence pinpointed the need for training for healthcare 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.

Interventions to improve social network in older people with sensory impairment: a systematic review

“…Population aging has resulted in a notable epidemiological transition marked by an increase in the prevalence of chronic disease [ 1 ]. A considerable proportion of older people experience age-related hearing and/or vision impairment [ 2 ], with a notable proportion experiencing dual sensory impairment (DSI), which is the combination of hearing and vision impairment [ 3 ]. According to World Health Organization (WHO) criteria, hearing impairment refers to hearing impairment more than 25 decibels in ears with better hearing, and vision impairment refers to vision below 0.3 logMAR (e.g., 20/40 or 6/12) [ 4 ].…”

“…According to World Health Organization (WHO) criteria, hearing impairment refers to hearing impairment more than 25 decibels in ears with better hearing, and vision impairment refers to vision below 0.3 logMAR (e.g., 20/40 or 6/12) [ 4 ]. Any degree of vision and hearing impairment, regardless of severity, age, or order of onset, is defined as DSI [ 3 , 5 , 6 ]. WHO estimated that more than 1.5 billion people worldwide are affected by hearing impairment, with 430 million experiencing moderate to severe hearing impairment [ 7 ].…”