Self-reported hearing, vision and quality of life: Older people in New Zealand

The effect of hearing aid treatment on health-related quality of life in older adults with hearing loss

OBJECTIVE

To investigate the effect of hearing aid (HA) intervention on long-term health-related quality of life (HRQoL) changes in first-time and experienced HA users using the 15D questionnaire. Secondly, the study explored the relationship between clinical parameters and changes in 15D scores.

DESIGN

A prospective observational study.

STUDY SAMPLE

The study population included 1562 patients (1113 first-time and 449 experienced HA users) referred for HA rehabilitation. All patients responded to the 15D at baseline, two months after HA fitting, and at long-term follow-up (698 ± 298 d).

RESULTS

Among both first-time and experienced HA users, significant improvements in hearing-dimension (15D-3) score were observed at two-month follow-up which sustained at long-term follow-up. 15D total scores significantly decreased at long-term follow-up. Self-reported hearing abilities, word recognition scores, and HA use time were significantly and positively correlated to increased 15D.

CONCLUSIONS

Both groups of HA users reported improved hearing-related QoL after HA treatment which sustained at long-term follow-up but the improvement in total 15D total score did not sustain for either group. The results suggest that HA intervention positively affects hearing-related QoL among older adults with hearing loss, and the findings support the use of 15D as a tool for the evaluation of HA treatment effects.

Self-reported dual sensory impairment and related factors: a European population-based cross-sectional survey

BACKGROUND

Data on population-based self-reported dual vision and hearing impairment are sparse in Europe. We aimed to investigate self-reported dual sensory impairment (DSI) in European population.

METHODS

A standardised questionnaire was used to collect medical and socio-economic data among individuals aged 15 years or more in 29 European countries. Individuals living in collective households or in institutions were excluded from the survey.

RESULTS

Among 296 677 individuals, the survey included 153 866 respondents aged 50 years old or more. The crude prevalence of DSI was of 7.54% (7.36-7.72). Among individuals aged 60 or more, 9.23% of men and 10.94% of women had DSI. Eastern and southern countries had a higher prevalence of DSI. Multivariable analyses showed that social isolation and poor self-rated health status were associated with DSI with ORs of 2.01 (1.77-2.29) and 2.33 (2.15-2.52), while higher income was associated with lower risk of DSI (OR of 0.83 (0.78-0.89). Considering country-level socioeconomic factors, Human Development Index explained almost 38% of the variance of age-adjusted prevalence of DSI.

CONCLUSION

There are important differences in terms of prevalence of DSI in Europe, depending on socioeconomic and medical factors. Prevention of DSI does represent an important challenge for maintaining quality of life in elderly population.

Influence of Hearing Loss on Social Participation in Older Adults: Results From a Scoping Review

This study aimed to provide a comprehensive understanding of the influence of hearing loss on social participation in older adults and including its facilitators and barriers. Following the rigorous methodological framework of scoping studies, nine multidisciplinary databases were searched with 44 keywords. Published mainly in the last decade, 41 studies using primarily a quantitative cross-sectional design were selected. Older adults with hearing loss have been found to have difficulty maintaining relationships and social activities. While social support and engaged-coping strategies were major facilitators of social participation, barriers included greater hearing loss, communication difficulties, comorbidities and reduced mental health. To better promote the social participation of older adults, early detection of hearing loss, holistic assessment, and interprofessional collaboration must be considered. Future research is necessary to better address the stigma related to hearing loss in older adults and challenges of early detection, and to propose innovative solutions to develop interprofessional collaboration.

Decreased Visual Search Behavior in Elderly Drivers during the Early Phase of Reverse Parking, But an Increase during the Late Phase

The aim of this study was to assess the characteristics of visual search behavior in elderly drivers in reverse parking. Fourteen healthy elderly and fourteen expert drivers performed a perpendicular parking task. The parking process was divided into three consecutive phases (Forward, Reverse, and Straighten the wheel) and the visual search behavior was monitored using an eye tracker (Tobii Pro Glasses 2). In addition, driving-related tests and quality of life were evaluated in elderly drivers. As a result, elderly drivers had a shorter time of gaze at the vertex of the parking space both in direct vision and reflected in the driver-side mirror during the Forward and the Reverse phases. In contrast, they had increased gaze time in the passenger-side mirror in the Straighten the wheel phase. Multiple regression analysis revealed that quality of life could be predicted by the total gaze time in the Straighten the wheel phase (β = -0.45), driving attitude (β = 0.62), and driving performance (β = 0.58); the adjusted R2 value was 0.87. These observations could improve our understanding of the characteristics of visual search behavior in parking performance and how this behavior is related to quality of life in elderly drivers.

Dementia and cataract surgery in Australia and New Zealand

BACKGROUND

Cataract surgery improves quality of life and reduces cognitive deterioration.

OBJECTIVES

This paper discusses the health implications of low vision, commonly related to cataracts, in older adults. A recent publication reported that cataract surgery reduces the risk of dementia by 30% over 10 years.

METHODS

We searched Medline from inception to January 2023. We also conducted backward and forward citation searches of included studies and set up alerts to identify studies published after the search date. We performed discussion groups with multidisciplinary experts.

RESULTS

This article provides a broad description of the importance of vision for cognitive function. We discuss access to public-funded cataract surgery in Australia and New Zealand and how this impacts population benefits.

CONCLUSIONS

We have evidence that cataract surgery can decrease the risk of dementia. This is an important topic that deserves recognition as part of an overall ageing response by policymakers and health professionals.

Health-related quality of life associated with sensory impairment in Chinese middle-aged and older adults: a cohort study

BACKGROUND

The impact of sensory impairment (SI) on individual multidimensional health has not been adequately explored in developing countries. This study examined the association of hearing or/and visual impairment with health-related quality of life (HRQoL) in the Chinese middle-aged and older population, and further explored potential discrepancies in associations by gender and rural-urban residence.

METHODS

This cohort study used four-wave data during 2011-2018 from the China Health and Retirement Longitudinal Study, and enrolled 13 342 community-dwelling adults aged 45 years or older. We employed linear mixed effects models to estimate the longitudinal associations between SI and HRQoL, and conducted interaction tests to assess gender or rural-urban differences in above associations.

RESULTS

Hearing impairment (HI) and visual impairment (VI) were separately and jointly associated with deteriorated overall HRQoL and decreased physical/mental component of HRQoL (all β<0, all p<0.05), and in particular, dual sensory impairment (DSI) exhibited greater impacts on HRQoL than either HI or VI alone. The impacts of SI on HRQoL were more evident among women or rural population than their counterparts (all p for interaction<0.05).

CONCLUSION

This study observed decreased HRQoL in association with SI. The greater impact of DSI underlines the need for integrated care for comorbid sensory conditions. Our findings also indicate the necessity to reduce the burden of SI among more vulnerable populations such as females and rural adults.

Psychological distress and well-being among sensory impaired individuals during COVID-19 lockdown measures

PURPOSE

Hearing and vision impairment are prevalent chronic conditions associated with poorer mental health. Limitations of in-person contacts during COVID-19-related lockdown measures may affect those with sensory impairments more severely exacerbating mental health problems. We aimed to determine whether hearing and/or visual impairment were associated with more psychological distress during a time of lockdown measures in Spring/Summer 2020 in Wisconsin.

METHODS

We included 1341(64% women, aged 20-92 years) Survey of the Health of Wisconsin COVID-19 survey participants (May 2020-July,2020). We assessed self-reported current mental health and well-being and vision and hearing impairment. Logistic regression models with sensory impairments as determinants and mental health outcomes were adjusted for age, gender, race, education, heart disease, hypertension, hyperlipidemia, and diabetes.

RESULTS

Vision impairment was associated with increased odds of generalized anxiety disorder (odds ratio = 2.10; 95% confidence interval = 1.32-3.29) and depressive symptoms (2.57;1.58-4.11), greater likelihood to report loneliness (1.65;1.00-2.64) and hopelessness (1.45;1.01-2.08). Hearing impaired individuals reported more loneliness (1.80;1.05-2.98) and hopelessness (1.42;0.99-2.03). Exploratory analyses revealed that sensory impaired individuals less often chose walking as a coping strategy during the pandemic.

CONCLUSIONS

Individuals with sensory impairment may represent a particularly vulnerable population during the COVID-19 pandemic. Future research should determine underlying reasons and interventions to mitigate this populations' disadvantages.

Positive psychology and attitudes to ageing in people aged 50 and over in the United Kingdom

Objectives: The aim of this study was to investigate whether attitudes to ageing were associated with attitudes to positive psychology constructs.Methods: A cross-sectional online survey of 572 UK adults aged 50+ (mean age 64.6 years, SD = 8.4, 73.8% female) assessed attitudes to ageing using the Attitudes to Ageing Questionnaire (AAQ) in relation to measures of positive psychology including (1) belief in a just world-Just World Scale (JWS-Self and JWS-Other), (2) sense of coherence-Sense of Coherence Scale (SOC) and (3) positive well-being-Control, Autonomy, Self-Realization, and Pleasure Scale (CASP-19). Other factors included difficulties with hearing and eyesight, relative and carer status and demographics.Results: People with hearing and eyesight difficulties had lower CASP-19 and SOC scores, and more negative attitudes to ageing compared to people without sensory problems. Hierarchical regression analyses showed all three positive psychology scales predicted more positive attitudes to ageing. Being a carer for a person with dementia was associated with more negative attitudes to ageing.Conclusion: Whereas health and sensory problems relate to more negative attitudes to ageing, this study highlights the importance of positive psychological factors which could inform approaches seeking to promote well-being and health in older people.

Self-rated health and hearing disorders: study of the Brazilian hearing-impaired population

Hearing impairment (HI) is one of the most impacting handicaps related to social life, and 21% have intense limitation compromising daily activities. However, few studies have investigated SRH in HI. This article aims to verify the association between HI and SRH and factors related to hearing characteristics. Cross-sectional study data from National Health Survey (NHS, 2013) conducted with 1,100 hearing impaired adults (≥18 years old). The outcome was SHR, categorized as good or poor. Poisson regression with robust variance was used to calculate Prevalence Ratios. Sociodemographic variables and characteristics of HI, such as congenital or acquired HI, type of HI, wear hearing aids, and limitation were used in adjusted analysis. Poor SRH was more prevalent in acquired HI, limitation of daily activities, sociodemographic characteristics such as aging, female, black or other skin color, and lower schooling. Poor SRH is related to acquired HI, limitation of daily activities and sociodemographic conditions.

Change in quality of life and potentially associated factors in patients receiving home-based primary care: a prospective cohort study

Background

The trajectories for health-related quality of life of patients receiving home-based primary care are not well identified. Our objective was to investigate changes in the quality of life (QOL) and factors that affected the QOL of patients receiving home-based primary care.

Methods

Our prospective cohort study, the Observational study of Nagoya Elderly with HOme MEdical (ONE HOME) study, recruited 184 patients undergoing home-based primary care with a 5-year follow-up period. Patients’ demographic data, socioeconomic status, physical diseases, medication use, feeding intake status, nutritional status, and functional status were measured annually. The 4-item quality of life index (QOL-HC [home care]) including self-perceived and family-reported QOL ratings that had been developed and previously validated in home care settings was used. Linear regression models were used for cross-sectional and longitudinal analyses.

Results

The participants’ mean age was 78.8 ± 10.8 years, and 55.9% of the sample was male. Most patients were frail, disabled, and/or malnourished. Self-perceived and family-reported QOL scores dropped sequentially on annual follow-ups. In the multivariate longitudinal analysis, patients who were divorced (β = 1.74) had high baseline QOL scores (β = 0.75) and reported higher QOL ratings. In addition, high functional dependency was associated with a low self-perceived QOL rating, with a β-value of − 1.24 in the pre-bedridden group and − 1.39 in the bedridden group. Given the family-reported QOL rating, the baseline QOL scores (β = 0.50) and Mini-Nutritional Assessment–Short-Form scores (β = 0.37) were found to have positive associations with the QOL rating.

Conclusions

For the disabled receiving home-based primary care, independent functional status and divorce were positively associated with better self-perceived QOL, whereas nutritional status was correlated with better family-reported QOL.

Quality of life in older adults with sensory impairments: a systematic review

PURPOSE

Sensory impairments are common in older adults. Hearing and visual impairments affect their physical and mental health and quality of life adversely. However, systematic reviews of the relationship between hearing impairment, visual impairment, dual sensory impairment, and quality of life are scarce. The purpose of this systematic review was to determine the relationship between hearing impairment, visual impairment, dual sensory impairment, and quality of life.

METHODS

Searches of EMBASE, PubMed, CINAHL, MEDLINE, Cochrane Library, and Airiti Library were conducted between January 2006 and December 2017 using the keywords "quality of life," "life satisfaction," "well-being," "hearing impairment," and "visual impairment." Two authors independently assessed methodologic quality using a modified Downs and Black tool. Data were extracted by the first author and then cross-checked by the second author.

RESULTS

Twenty-three studies consisting mostly of community-dwelling older adults were included in our review. Sensory impairment was found to be in significant association with quality of life, with an increase in hearing impairment or visual impairment severity resulting in a lower quality of life. Quality of life for dual sensory impairment was worse than for hearing impairment or visual impairment individually.

CONCLUSIONS

A significant association was confirmed between hearing impairment, visual impairment, dual sensory impairment, and quality of life. Our review can be used to enhance health care personnel's understanding of sensory impairment in older adults and enable health care personnel to actively assess older adults' sensory functions, so that they can help alleviate the negative impact of sensory impairments on QOL in older adults.

Recruiting older people for research through general practice: the Brief Risk Identification Geriatric Health Tool trial

AIM

To describe successful methods of recruitment and identify practice characteristics related to increased recruitment of older people for a randomised controlled trial.

METHODS

General practices in three regions of New Zealand and community-dwelling patients aged 75+ were recruited for the Brief Risk Identification Geriatric Health Tool trial. General practitioners (GPs) were faxed invitations with telephone follow-up. Reply-paid cards with telephone follow-up were used to invite older people. GP and practice characteristics were examined in relationship to recruitment rate.

RESULTS

During 2007-2008, 158 of 438 GPs (36%) in 60 of 116 practices approached (52%) were recruited. Regional variation was marked and 3893 of 8308 invited (49%) older people were recruited. The GP's length of time at the practice and training in New Zealand was associated with recruitment success.

CONCLUSIONS

Despite variability in practice recruitment, a reasonably large and representative sample of older people was recruited through general practices.