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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.

Author information

1
Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK.
2
Institute of Applied Research, Development and Further Education, Catholic University of Freiburg, Freiburg, Germany.
3
Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, M139PL, UK.
4
Greater Manchester NIHR Clinical Research Network, Manchester University NHS Foundation Trust, 2nd Floor City Labs, Nelson Steer, Manchester, UK.
5
Department of Health Sciences, School of Sciences, European University Cyprus, 6 Diogenes Str, Nicosia, Cyprus.
6
Department of Psychology & Center for Applied Neuroscience, University of Cyprus, Kallipoleos 75, Nicosia, Cyprus.

Abstract

Background:

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

Objective:

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.

Methods:

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.

Results:

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.

Conclusions:

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.

PMID:
30608511
DOI:
10.1093/ageing/afy183

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