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Age Ageing. 2019 Jan 4. doi: 10.1093/ageing/afy183. [Epub ahead of print]

Assessing and managing concurrent hearing, vision and cognitive impairments in older people: an international perspective from healthcare professionals.

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Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK.
Institute of Applied Research, Development and Further Education, Catholic University of Freiburg, Freiburg, Germany.
Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, M139PL, UK.
Greater Manchester NIHR Clinical Research Network, Manchester University NHS Foundation Trust, 2nd Floor City Labs, Nelson Steer, Manchester, UK.
Department of Health Sciences, School of Sciences, European University Cyprus, 6 Diogenes Str, Nicosia, Cyprus.
Department of Psychology & Center for Applied Neuroscience, University of Cyprus, Kallipoleos 75, Nicosia, Cyprus.



there is a significant gap in the understanding, assessment and management of people with dementia and concurrent hearing and vision impairments.


from the perspective of professionals in dementia, hearing and vision care, we aimed to: (1) explore the perceptions of gaps in assessment and service provision in ageing-related hearing, vision and cognitive impairment; (2) consider potential solutions regarding this overlap and (3) ascertain the attitudes, awareness and practice, with a view to implementing change.


our two-part investigation with hearing, vision, and dementia care professionals involved: (1) an in-depth, interdisciplinary, international Expert Reference Group (ERG; n = 17) and (2) a wide-scale knowledge, attitudes and practice survey (n = 653). The ERG involved consensus discussions around prototypic clinical vignettes drawn from a memory centre, an audiology clinic, and an optometry clinic, analysed using an applied content approach.


the ERG revealed several gaps in assessment and service provision, including a lack of validated assessment tools for concurrent impairments, poor interdisciplinary communication and care pathways, and a lack of evidence-based interventions. Consensus centred on the need for flexible, individualised, patient-centred solutions, using an interdisciplinary approach. The survey data validated these findings, highlighting the need for clear guidelines for assessing and managing concurrent impairments.


this is the first international study exploring professionals' views of the assessment and care of individuals with age-related hearing, vision and hearing impairment. The findings will inform the adaptation of assessments, the development of supportive interventions, and the new provision of services.


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