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Int J Geriatr Psychiatry. 2019 Nov 11. doi: 10.1002/gps.5231. [Epub ahead of print]

Impact of an intervention to support hearing and vision in dementia: The SENSE-Cog Field Trial.

Author information

1
Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.
2
Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK.
3
Institute of Applied Research, Development and Further Education, Catholic University of Applied Sciences Freiburg, Freiburg, Germany.
4
Department of Communication Sciences and Disorders, University of South Florida, Tampa, FL.
5
Division of Psychology and Mental Health, University of Manchester, Manchester, UK.
6
Manchester Centre for Health Economics, University of Manchester, Manchester, UK.
7
Department of Health Sciences, European University Cyprus, Nicosia, Cyprus.
8
INSERM, EUCLID/F-CRIN Clinical Trials Platform, University of Bordeaux, Talence, Aquitaine, France.
9
Centre for Applied Neurosciences, University of Cyprus, Nicosia, Cyprus.
10
Manchester Centre for Audiology and Deafness, University of Manchester, Manchester, UK.
11
Department of Audiology, Starkey Hearing Technologies, Stockport, UK.
12
Centre for Biostatistics, University of Manchester, Manchester, UK.
13
INSERM, Bordeaux Population Health Research Center, Team LEHA, University of Bordeaux, Talence, Aquitaine, France.
14
Research and Development, Essilor International, Paris, France.

Abstract

OBJECTIVES:

Hearing, vision, and cognitive impairment commonly co-occur in older adults. Improving sensory function may positively impact outcomes in people with dementia (PwD). We developed a "sensory intervention" (SI) to support hearing and vision in PwD. Here, we report the findings of an international open-label field trial, and nested case series, to explore the impact of the SI on dementia-related outcomes.

METHODS:

This was a home-based trial conducted in France, England, and Cyprus. Participants were people with mild-to-moderate dementia and hearing and/or vision impairment (n = 19) and their study partners (unpaid carers; n = 19). The "basic" SI included a hearing and vision assessment and provision of glasses and/or hearing aids. A subsample received the "extended" SI with additional weekly visits from a sensory support therapist (SST). Exploratory analyses of dementia-related, health utility and resource utilisation outcomes were performed.

RESULTS:

Quality of life (QoL) and sensory functional ability improved. Change in QoL exceeded the threshold for a minimum clinically important difference. There was a modest improvement (in absolute terms) post intervention in behavioural disturbance, self-efficacy, and relationship satisfaction. Study partner time assisting instrumental activities of daily living (iADL) and supervision decreased by about 22 and 38 hours per month, respectively, although time for personal ADL support increased. Qualitative data supported effectiveness of the intervention: PwD were more socially engaged, less isolated, less dependent on study partners, and had improved functional ability and communication.

CONCLUSIONS:

These findings support the need for a definitive randomised controlled trial (RCT) to evaluate the effectiveness of the intervention.

KEYWORDS:

complex intervention; dementia; hearing impairment; quality of life; resource utilisation; vision impairment

PMID:
31713262
DOI:
10.1002/gps.5231

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