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Yang L, Luo Y. The interrelationships of hearing function, allostatic load, and cognitive function: Evidence among middle-aged and older Chinese adults. Arch Gerontol Geriatr 2024; 117:105205. [PMID: 37741136 DOI: 10.1016/j.archger.2023.105205] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/30/2023] [Accepted: 09/17/2023] [Indexed: 09/25/2023]
Abstract
OBJECTIVES We aim to examine the interrelationships of self-reported hearing function, allostatic load (AL), and cognitive function among middle aged and older adults. METHODS Our data were collected from two waves of the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011 and 2015. The participants' hearing function was measured using self-rated subjective hearing function. Allostatic load (AL) was evaluated by measuring 14 biomarkers associated with physiological health, which were derived from blood samples. Cognitive function was assessed using three domains: episodic memory, mental intactness, and global cognition. To examine the relationships between hearing function, AL, and cognitive function, path analysis with structural equation modeling (SEM) methodology was employed. RESULTS Among individuals aged 60 and above non-hearing aids users, the hearing function at Time 1 (T1) in 2011 has a significant association with the level of AL at T1 (β = 0.02, p < 0.001), as well as on cognitive function at Time 2 (T2) in 2015 (β = -0.1, p < 0.001). Additionally, the AL related to the hearing function at T1 associates an increased risk of AL at T2 (β = 0.5, p < 0.001), and is significantly associated with a decrease of cognitive function scores at T2 (β = -0.4, p < 0.001). However, no significant relationship was found among individuals aged 45 - 59 with non-hearing aids utilizers. Similar findings were in the domains of epidemic memory and mental intactness for cognitive function. CONCLUSIONS There were interrelationships of subjective hearing function, AL, and cognitive function among aged 60 years and above, but not among those aged 45-59 years old. It may provide valuable insights for identifying subclinical thresholds in the physiological systems of individuals at risk of pathology in cognitive function.
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Affiliation(s)
- Lei Yang
- School of Public Administration, Beihang University, Beijing, 100191, China
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, 100191, China.
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2
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Chen F, Chen Y, Jiang X, Li X, Ning H, Hu M, Jiang W, Zhang N, Feng H, Yan P. Impact of hearing loss on cognitive function in community-dwelling older adults: serial mediation of self-rated health and depressive anxiety symptoms. Front Aging Neurosci 2023; 15:1297622. [PMID: 38155735 PMCID: PMC10753014 DOI: 10.3389/fnagi.2023.1297622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/27/2023] [Indexed: 12/30/2023] Open
Abstract
Background Hearing loss can exacerbate cognitive decline; therefore, exploring the mechanisms through which hearing loss affects cognitive function is crucial. The current study aimed to investigate the impact of hearing loss on cognitive function and the mediating role played by self-rated health and depressive anxiety symptoms. Methods Using stratified whole-group random sampling, the study employed a cross-sectional design and included 624 participants aged ≥65 years from three communities in Urumqi, China. Cognitive function was assessed using the Mini-Mental State Examination. Hearing function and self-rated health were determined by self-report. The 15-item Geriatric Depression Scale and the 7-item Generalized Anxiety Disorder Scale were used to assess depressive anxiety symptoms. Serial mediation analysis was performed using AMOS 26.0. Results Hearing loss can not only negatively affect cognitive function in older adults directly (direct effect = -0.106; SE = 0.045; 95% confidence interval (CI): -0.201 to -0.016), but also indirectly affect the relationship between hearing loss and cognitive function through self-rated health and depressive anxiety symptoms. The results of the serial mediation analysis showed that the total indirect effect of self-rated health and depressive anxiety symptoms was -0.115 (95% CI: -0.168 to -0.070), and the total effect of the model was -0.221 (95% CI: -0.307 to -0.132), with the total indirect effect accounting for 52.04% of the total effect of the model. Conclusion Our study discovered that there is a partial mediation of the relationship between hearing loss and cognitive function by self-rated health and depressive anxiety symptoms. It is suggested that by enhancing self-rated health and ensuring good mental health, the decline in cognitive function among older adults with hearing loss can be delayed.
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Affiliation(s)
- Fenghui Chen
- Xiangya Nursing School, Central South University, Changsha, China
- Nursing School, Xinjiang Medical University, Urumqi, China
| | - Yingying Chen
- Nursing School, Xinjiang Medical University, Urumqi, China
| | - Xin Jiang
- Nursing School, Xinjiang Medical University, Urumqi, China
| | - Xiaoyang Li
- Xiangya Nursing School, Central South University, Changsha, China
| | - Hongting Ning
- Xiangya Nursing School, Central South University, Changsha, China
| | - Mingyue Hu
- Xiangya Nursing School, Central South University, Changsha, China
| | - Wenxin Jiang
- Nursing School, Xinjiang Medical University, Urumqi, China
| | - Nan Zhang
- Nursing School, Xinjiang Medical University, Urumqi, China
| | - Hui Feng
- Xiangya Nursing School, Central South University, Changsha, China
| | - Ping Yan
- Nursing School, Xinjiang Medical University, Urumqi, China
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3
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Zhang W, Roberts TV, Poulos CJ, Stanaway FF. Prevalence of visual impairment in older people living with dementia and its impact: a scoping review. BMC Geriatr 2023; 23:63. [PMID: 36726055 PMCID: PMC9890816 DOI: 10.1186/s12877-022-03581-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 11/03/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Visual impairment (VI) and dementia both increase with age, and it is likely that many older people are living with both conditions. This scoping review aims to investigate the prevalence and types of VI among older people living with dementia, and the impact of VI on older people living with dementia and their caregivers. METHODS This scoping review used Arksey and O'Malley's methodological framework. Studies in any setting involving people living with dementia and some assessment of either VI, eye diseases causing VI or the impact of VI were included. RESULTS Thirty-six studies were included. Thirty-one studies reported the prevalence of VI in older people living with dementia, while ten studies reported on impacts of VI on people living with dementia. Only one study reported on impacts on caregivers. The prevalence of VI or specific eye diseases among older people living with dementia ranged from 0.2 to 74%. The impacts of VI on older people living with dementia included increased use of hospital services, increased disability and dependency, reduced social engagement, negative emotions, increased abnormal behaviours, loss of hobbies, difficulty in using visual aids or memory aids, and greater Neuropsychiatric Inventory symptoms. And the impacts on caregivers included increased conflict and physical exhaustion. CONCLUSION VI is common in older people living with dementia and is associated with negative impacts on those with dementia and their caregivers. However, heterogeneity between studies in terms of setting and method for assessing and defining VI make it difficult to compare findings among studies. Further research is needed, particularly assessing the impact on caregivers.
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Affiliation(s)
- Wanyu Zhang
- grid.1013.30000 0004 1936 834XSchool of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006 Australia
| | - Timothy V. Roberts
- grid.1013.30000 0004 1936 834XSydney Medical School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Sydney, NSW 2006 Australia ,grid.412703.30000 0004 0587 9093Department of Ophthalmology, Royal North Shore Hospital, Reserve Rd, St Leonards, NSW 2065 Australia ,grid.419000.c0000 0004 0586 7447Vision Eye Institute, Level 3, 270 Victoria Ave, Chatswood, Sydney, NSW 2067 Australia
| | - Christopher J. Poulos
- HammondCare, 4/207B Pacific Hwy, St Leonards, Sydney, NSW 2065 Australia ,grid.1005.40000 0004 4902 0432School of Population Health, The University of NSW, Samuels Building, Samuel Terry Ave, Kensington, Sydney, NSW 2033 Australia
| | - Fiona F. Stanaway
- grid.1013.30000 0004 1936 834XSchool of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006 Australia
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Tan BKJ, Ng FYC, Song HJJMD, Tan NKW, Ng LS, Loh WS. Associations of Hearing Loss and Dual Sensory Loss With Mortality: A Systematic Review, Meta-analysis, and Meta-regression of 26 Observational Studies With 1 213 756 Participants. JAMA Otolaryngol Head Neck Surg 2022; 148:220-234. [PMID: 34967895 PMCID: PMC8719275 DOI: 10.1001/jamaoto.2021.3767] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
IMPORTANCE Hearing loss (HL) and dual sensory loss (DSL) are prevalent, disabling, and associated with numerous age-related health conditions, including dementia and frailty. To date, no evidence-based summary of their mortality risk is available. OBJECTIVE To clarify the epidemiological associations between HL/DSL and mortality. DATA SOURCES PubMed, Embase, and Cochrane Library, from inception until June 18, 2021. STUDY SELECTION Two blinded reviewers selected observational or interventional studies, published as full-length English articles in peer-reviewed journals, that reported the presence or severity of HL or DSL (ie, comorbid HL and vision loss), whether objectively measured or self-reported, in association with any mortality estimate, among adults 18 years and older. DATA EXTRACTION AND SYNTHESIS Two reviewers extracted data and evaluated study bias using the Newcastle-Ottawa Scale, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)/Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines and a PROSPERO-registered protocol. The analysis pooled maximally adjusted estimates using mixed-effects models, measured heterogeneity using I2, investigated sources of heterogeneity using meta-regression and subgroup meta-analyses, examined and adjusted for publication bias, performed influence and cumulative meta-analyses, and assessed evidence quality using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. MAIN OUTCOMES AND MEASURES Hazard ratios (HRs) for all-cause, cardiovascular, or other mortality estimates. RESULTS This review included 14 retrospective and 12 prospective observational studies (1 213 756 participants) from 3220 records. Risk of bias was low to moderate; exclusion of 3 high-risk studies did not alter conclusions. Hearing loss was associated with excess all-cause mortality (HR, 1.13; 95% CI, 1.07-1.19; I2 = 77%; n = 21; 95% prediction interval [PI], 0.93-1.37) and cardiovascular mortality (HR, 1.28; 95% CI, 1.10-1.50; I2 = 60%; n = 6; 95% PI, 0.84-1.96), while DSL was associated with larger excess risks (all-cause: HR, 1.40; 95% CI, 1.30-1.51; I2 = 34%; n = 10; 95% PI, 1.18-1.66; cardiovascular: HR, 1.86; 95% CI, 1.31-2.65; I2 = 0%; n = 2), after adjustment for demographics and comorbidities. Prespecified meta-regression sufficiently explained heterogeneity, with longer follow-up duration weakening the pooled association, leaving low (29%) residual heterogeneity. Meta-regression among audiometric studies showed a dose-response association (doubling of HR per 30-dB increase in HL). Self-reported and audiometric effect sizes were similar, with lower heterogeneity in the latter. Associations were robust to trim-and-fill adjustment for publication bias and single-study influence and cumulative meta-analyses. Associations with accident/injury, cancer, and stroke mortality were inconclusive, with only 1 to 3 studies. Overall evidence quality was moderate. CONCLUSIONS AND RELEVANCE In this systematic review and meta-analysis, HL and DSL were associated with excess all-cause and cardiovascular mortality. Physicians caring for patients with HL should consider its relevance to general health and longevity.
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Affiliation(s)
- Benjamin Kye Jyn Tan
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore
| | - Faye Yu Ci Ng
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore
| | | | - Nicole Kye Wen Tan
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore
| | - Li Shia Ng
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore,Department of Otolaryngology–Head & Neck Surgery, National University Health System (NUHS), Singapore
| | - Woei Shyang Loh
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore,Department of Otolaryngology–Head & Neck Surgery, National University Health System (NUHS), Singapore
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A Newly Identified Impairment in Both Vision and Hearing Increases the Risk of Deterioration in Both Communication and Cognitive Performance. Can J Aging 2021; 41:363-376. [DOI: 10.1017/s0714980821000313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
Vision and hearing impairments are highly prevalent in adults 65 years of age and older. There is a need to understand their association with multiple health-related outcomes. We analyzed data from the Resident Assessment Instrument for Home Care (RAI-HC). Home care clients were followed for up to 5 years and categorized into seven unique cohorts based on whether or not they developed new vision and/or hearing impairments. An absolute standardized difference (stdiff) of at least 0.2 was considered statistically meaningful. Most clients (at least 60%) were female and 34.9 per cent developed a new sensory impairment. Those with a new concurrent vison and hearing impairment were more likely than those with no sensory impairments to experience a deterioration in receptive communication (stdiff = 0.68) and in cognitive performance (stdiff = 0.49). After multivariate adjustment, they had a twofold increased odds (adjusted odds ratio [OR] = 2.1; 95% confidence interval [CI]:1,87, 2.35) of deterioration in cognitive performance. Changes in sensory functioning are common and have important effects on multiple health-related outcomes.
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Assi L, Ehrlich JR, Zhou Y, Huang A, Kasper J, Lin FR, McKee MM, Reed NS, Swenor BK, Deal JA. Self-reported dual sensory impairment, dementia, and functional limitations in Medicare beneficiaries. J Am Geriatr Soc 2021; 69:3557-3567. [PMID: 34478566 PMCID: PMC8648982 DOI: 10.1111/jgs.17448] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 01/19/2023]
Abstract
BACKGROUND Vision and hearing impairments often co-exist with dementia, and all are independently associated with limitations in daily activities. Our aim was to examine the association of dual sensory impairment with functional limitations, and further examine the combined estimated association of sensory impairment and dementia with these functional limitations. METHODS Cross-sectional analysis of the National Health and Aging Trends Study (NHATS), a population-based cohort of Medicare beneficiaries, was performed. Participants were selected from the 2015 round. Survey weighted Poisson regression models adjusted for dementia, demographics, and health status variables examined the association of self-reported dual sensory impairment (no sensory impairment, single sensory impairment, dual sensory impairment) with scores of limitations in mobility, self-care, and household activities. Models were repeated to take into account the combined effects of dual sensory impairment and dementia. RESULTS Overall, 7124 participants representative of Medicare beneficiaries 65 years or older were included. Of them, 43.9% were 75 years or older and 55.3% were female. Older adults with dual sensory impairment had greater limitations with mobility (prevalence rate ratio [PRR] = 1.45, 95% CI = 1.28-1.63), self-care (PRR = 1.41, 95% CI = 1.25-1.59), and household activities (PRR = 1.54, 95% CI = 1.37-1.72) compared with those without sensory impairment. They also had greater limitations than those with a single sensory impairment across the different activity categories. In models taking into account the combined estimated effect of both sensory impairment and dementia, those with dual sensory impairment and dementia had greater limitations than those without sensory impairment or dementia in each category (mobility: PRR = 1.85, 95% CI = 1.59-2.14, self-care: PRR = 1.86, 95% CI = 1.59-2.18, household: PRR = 2.41, 95% CI = 2.09-2.77). CONCLUSIONS Older adults with dual sensory impairment had greater functional limitations compared with those without sensory impairment and those with a single sensory impairment. Strategies to improve visual and/or hearing function (e.g., sensory aids, rehabilitation) could potentially help prevent or minimize disability, even among those with dementia.
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Affiliation(s)
- Lama Assi
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,Department of Ophthalmology, Louisiana State University Health Sciences Center, New Orleans, LA
| | - Joshua R. Ehrlich
- Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, MI,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI,Institute for Social Research, University of Michigan Medical School, Ann Arbor, MI
| | - Yunshu Zhou
- Department of Ophthalmology and Visual Sciences, University of Michigan Medical School, Ann Arbor, MI
| | - Alison Huang
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Judith Kasper
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Frank R. Lin
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Michael M. McKee
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI,Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Nicholas S. Reed
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,The Disability Health Research Center, Johns Hopkins Bloomberg University, Baltimore, MD
| | - Bonnielin K Swenor
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,The Disability Health Research Center, Johns Hopkins Bloomberg University, Baltimore, MD,The Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD
| | - Jennifer A. Deal
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD,The Disability Health Research Center, Johns Hopkins Bloomberg University, Baltimore, MD
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7
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Liu CJ, Chang PS, Griffith CF, Hanley SI, Lu Y. The Nexus of Sensory Loss, Cognitive Impairment, and Functional Decline in Older Adults: A Scoping Review. THE GERONTOLOGIST 2021; 62:e457-e467. [PMID: 34131697 DOI: 10.1093/geront/gnab082] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The prevalence of cognitive impairment and sensory loss in hearing or vision increases with age. Based on the Information Processing Model, cognitive impairment coupled with sensory loss may exacerbate disability in late life. Yet this issue has not been systematically studied. The purpose of this scoping review was to examine the literature that studied the relationship between cognitive impairment, sensory loss, and activities of daily living in older adults. RESEARCH DESIGN AND METHODS Two reviewers independently screened 1,410 studies identified from five electronic databases (Medline, EMBASE, PsycINFO, CINHAL, and the Web of Science). The search was completed in June 2020. A study was eligible if it included measurements of cognitive function, vision or hearing, and activities of daily living. Additionally, the data analyses must address how cognitive impairment and sensory loss are related to the performance of activities of daily living. RESULTS The final review included 15 studies. Findings show an additive effect of cognitive impairment and sensory loss on the activities of daily living. Cognitive impairment or vision loss independently relates to the decline in activities of daily living. Hearing loss relates to the decline only when the loss is severe, or if the daily task is hearing specific. DISCUSSION AND IMPLICATIONS Older adults with coexisting sensory loss and cognitive impairment have the highest risk or prevalence of disability, comparing to cognitive impairment or sensory loss alone. This finding highlights the importance of developing interventions to reduce the risk of disability for older adults experiencing multiple impairments.
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Affiliation(s)
- Chiung-Ju Liu
- Department of Occupational Therapy, University of Florida College of Public Health and Health Professions, Gainesville, Florida, USA
| | - Pei-Shiun Chang
- Department of Community and Health Systems, Indiana University School of Nursing, Bloomington, Indiana, USA
| | - Cheryl F Griffith
- Academic Affairs, Office of Clinical Education, Indiana University Health, Indianapolis, Indiana, USA
| | - Stephanie I Hanley
- Department of Occupational Therapy, University of Florida College of Public Health and Health Professions, Gainesville, Florida, USA
| | - Yvonne Lu
- Indiana University School of Nursing, Indianapolis, Indiana, USA
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8
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Wittich W, Pichora-Fuller MK, Johnson A, Joubert S, Kehayia E, Bachir V, Aubin G, Jaiswal A, Phillips N. Effect of Reading Rehabilitation for Age-Related Macular Degeneration on Cognitive Functioning: Protocol for a Nonrandomized Pre-Post Intervention Study. JMIR Res Protoc 2021; 10:e19931. [PMID: 33704074 PMCID: PMC7995070 DOI: 10.2196/19931] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 08/24/2020] [Accepted: 02/24/2021] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Age-related vision impairments and dementia both become more prevalent with increasing age. Research into the mechanisms of these conditions has proposed that some of their causes (eg, macular degeneration/glaucoma and Alzheimer's disease) could be symptoms of an underlying common cause. Research into sensory-cognitive aging has provided data that sensory decline may be linked to the progression of dementia through reduced sensory stimulation. While hearing loss rehabilitation may have a beneficial effect on cognitive functioning, there are no data available on whether low vision rehabilitation, specifically for reading, could have a beneficial effect on cognitive health. OBJECTIVE The research questions are: (1) Does low vision rehabilitation reduce reading effort? (2) If so, does reduced reading effort increase reading activity, and (3) If so, does increased reading activity improve cognitive functioning? The primary objective is to evaluate cognition before, as well as at 6 months and 12 months after, 3 weeks of low vision reading rehabilitation using magnification in individuals with age-related macular degeneration, with or without coexisting hearing impairments. We hypothesize that improvements postrehab will be observed at 6 months and maintained at 12 months for participants with vision loss and less so for those with dual sensory loss. The secondary objective is to correlate participant characteristics with all cognitive outcomes to identify which may play an important role in reading rehabilitation. METHODS We employ a quasiexperimental approach (nonrandomized, pre-post intervention study). A 3x3 design (3 groups x 3 time points) allows us to examine whether cognitive performance will change before and after 6 months and 12 months of a low vision reading intervention, when comparing 75 low vision and 75 dual sensory impaired (vision & hearing) participants to 75 age-matched healthy controls. The study includes outcome measures of vision (eg, reading acuity and speed), cognition (eg, short-term and long-term memory, processing speed), participant descriptors, demographics, and clinical data (eg, speech perception in noise, mental health). RESULTS The study has received approval, and recruitment began on April 24, 2019. As of March 4, 2021, 38 low vision and 7 control participants have been enrolled. Lockdown forced a pause in recruitment, which will recommence once the COVID-19 crisis has reached a point where face-to-face data collection with older adults becomes feasible again. CONCLUSIONS Evidence of protective effects caused by reading rehabilitation will have a considerable impact on the vision rehabilitation community and their clients as well as all professionals involved in the care of older adults with or without dementia. If we demonstrate that reading rehabilitation has a beneficial effect on cognition, the demand for rehabilitation services will increase, potentially preventing cognitive decline across groups of older adults at risk of developing macular degeneration. TRIAL REGISTRATION ClinicalTrials.gov NCT04276610; Unique Protocol ID: CRIR-1284-1217; https://clinicaltrials.gov/ct2/show/NCT04276610. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19931.
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Affiliation(s)
- Walter Wittich
- School of Optometry, Université de Montréal, Montreal, QC, Canada.,Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada.,Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montreal, QC, Canada.,Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montreal, QC, Canada.,Department of Psychology, Concordia University, Montreal, QC, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | | | - Aaron Johnson
- Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montreal, QC, Canada.,Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montreal, QC, Canada.,Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Sven Joubert
- Department of Psychology, Université de Montréal, Montreal, QC, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, QC, Canada
| | - Eva Kehayia
- Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montreal, QC, Canada.,School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Vanessa Bachir
- School of Optometry, Université de Montréal, Montreal, QC, Canada.,Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montreal, QC, Canada
| | - Gabrielle Aubin
- Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada.,Centre de réadaptation Lethbridge-Layton-Mackay du CIUSSS du Centre-Ouest-de-l'Île-de-Montréal, Montreal, QC, Canada.,Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montreal, QC, Canada.,Department of Psychology, Université de Montréal, Montreal, QC, Canada
| | - Atul Jaiswal
- School of Optometry, Université de Montréal, Montreal, QC, Canada.,Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Longueuil, QC, Canada.,Center for Interdisciplinary Rehabilitation Research of Greater Montreal, Montreal, QC, Canada
| | - Natalie Phillips
- Department of Psychology, Concordia University, Montreal, QC, Canada
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Navarrete-Reyes AP, Animas-Mijangos K, Gómez-Camacho J, Juárez-Carrillo Y, Torres-Pérez AC, Cataneo-Piña DJ, Negrete-Najar JP, Soto-Perez-de-Celis E. Geriatric principles for patients with cancer. GERIATRICS, GERONTOLOGY AND AGING 2021. [DOI: 10.5327/z2447-212320212100009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Cancer is primarily a disease of older persons. Given the heterogeneity of aging, physiological age, rather than chronological age, better expresses the cumulative effect of environmental, medical, and psychosocial stressors, which modifies life expectancy. Comprehensive geriatric assessment, a tool that helps ascertain the physiological age of older individuals, is the gold standard for assessing older adults with cancer. Several international organizations recommend using the geriatric assessment domains to identify unrecognized health problems that can interfere with treatment and predict adverse health-related outcomes, aiding complex treatment decision making. More recently, it has been shown that geriatric assessment-guided interventions improve quality of life and mitigate treatment toxicity without compromising survival. In this review, we discuss the role of comprehensive geriatric assessment in cancer care for older adults and provide the reader with useful information to assess potential treatment risks and benefits, anticipate complications, and plan interventions to better care for older people with cancer.
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10
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Ye X, Zhu D, Chen S, He P. The association of hearing impairment and its severity with physical and mental health among Chinese middle-aged and older adults. Health Qual Life Outcomes 2020; 18:155. [PMID: 32456646 PMCID: PMC7249342 DOI: 10.1186/s12955-020-01417-w] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 05/22/2020] [Indexed: 11/16/2022] Open
Abstract
Background Hearing impairment is a common chronic condition which can be closely related to people’s health. However, current studies on this topic are quite limited in developing countries, and few with standardized audiometric measurement and multiple health outcomes. Therefore, we aimed to explore the association between hearing impairment and its severity with physical and mental health among Chinese middle-aged and older adults. Methods We obtained data from two sources: (1) China Health and Retirement Longitudinal Study (CHARLS) 2011, 2013, and 2015, in which hearing impairment was measured by asking whether participants aged 45 years old had hearing problems; and (2) Hearing Survey 2019, the baseline survey of a randomized controlled trial conducted in Shandong Province of China, including 376 middle-aged and older participants. The severity of hearing impairment was identified by pure tone average of hearing thresholds at 0.5, 1, 2, and 4 kHz. Results In CHARLS, 1248 (8.36%) participants suffered from hearing impairment at baseline, and hearing-impaired individuals were more likely to have chronic diseases, impaired activities of daily living (ADLs), impaired instrumental activities of daily living (IADLs) and depressive symptoms. For the 376 hearing-impaired participants in Hearing Survey 2019, 30.32, 38.30 and 31.38% of them had moderate, severe and profound hearing impairment, respectively. As the severity of hearing impairment increased, individuals were likely to have impaired ADLs, impaired IADLs and depressive symptoms. Conclusions Hearing impairment and its severity were closely related to multiple physical and mental health outcomes among Chinese middle-aged and older adults. Actions should be taken to prevent and treat hearing impairment, so as to improve people’s health and well-being.
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Affiliation(s)
- Xin Ye
- School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,China Center for Health Development Studies, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Dawei Zhu
- China Center for Health Development Studies, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Siyuan Chen
- School of Public Health, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.,China Center for Health Development Studies, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China
| | - Ping He
- China Center for Health Development Studies, Peking University, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.
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11
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Tareque MI, Chan A, Saito Y, Ma S, Malhotra R. The Impact of Self-Reported Vision and Hearing Impairment on Health Expectancy. J Am Geriatr Soc 2019; 67:2528-2536. [PMID: 31411348 DOI: 10.1111/jgs.16086] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/04/2019] [Accepted: 06/26/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Vision and hearing impairment may impact both life expectancy (LE) and health expectancy, that is, duration of life with and without health problems, among older adults. We examined the impact of self-reported vision and hearing impairment on years of life with and without limitation in physical function and in activities of daily living (ADLs). DESIGN Life table analysis, using a nationally representative longitudinal survey of community-dwelling older adults aged 60 years or older, Panel on Health and Ageing of Singaporean Elderly. SETTING Singapore. PARTICIPANTS Survey participants (n = 3452) who were interviewed in 2009 and followed up in 2011-2012 and 2015. MEASUREMENTS Participants reporting difficulty with any of nine tasks involving upper or lower extremities were considered to have a limitation in physical function. Those reporting health-related difficulty with any of six basic ADLs or seven instrumental ADLs were considered to have a limitation in ADLs. We used the multistate life table method with a microsimulation approach to estimate health expectancy, considering self-reported sensory impairment status as time varying. RESULTS Either or both impairments, vs neither, were associated with less years without limitation in physical function and in ADLs and more years with limitation in physical function and in ADLs, with the greatest impact on health expectancy among those with both impairments, who also had the lowest LE. For example, at age 60, those with both impairments, vs neither, could expect not only shorter LE (4.2 [95% confidence interval [CI] = 1.9-5.7] less years; 20.7 [95% CI = 18.9-22.5] vs 24.9 [95% CI = 23.8-26.0]) but also more years of life with limitations in physical function (3.3 [95% CI = .9-5.8] more years; 12.8 [95% CI = 10.7-14.8] [about 61.7% of LE] vs 9.5 [95% CI = 8.4-10.5] [about 38.0% of LE]). CONCLUSION Timely and appropriate management of vision and hearing impairment, especially when coexisting, among older adults has the potential to reduce the years of life they live with limitation in physical function and in ADLs. J Am Geriatr Soc 67:2528-2536, 2019.
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Affiliation(s)
- Md Ismail Tareque
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh
| | - Angelique Chan
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore.,Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore
| | - Yasuhiko Saito
- College of Economics and Population Research Institute, Nihon University, Tokyo, Japan
| | - Stefan Ma
- Ministry of Health, Singapore, Singapore
| | - Rahul Malhotra
- Centre for Ageing Research and Education (CARE), Duke-NUS Medical School, Singapore, Singapore.,Health Services and Systems Research (HSSR), Duke-NUS Medical School, Singapore, Singapore
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12
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Deardorff WJ, Liu PL, Sloane R, Van Houtven C, Pieper CF, Hastings SN, Cohen HJ, Whitson HE. Association of Sensory and Cognitive Impairment With Healthcare Utilization and Cost in Older Adults. J Am Geriatr Soc 2019; 67:1617-1624. [PMID: 30924932 PMCID: PMC6684393 DOI: 10.1111/jgs.15891] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/22/2019] [Accepted: 02/22/2019] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To examine the association between self-reported vision impairment (VI), hearing impairment (HI), and dual-sensory impairment (DSI), stratified by dementia status, on hospital admissions, hospice use, and healthcare costs. DESIGN Retrospective analysis. SETTING Medicare Current Beneficiary Survey from 1999 to 2006. PARTICIPANTS Rotating panel of community-dwelling Medicare beneficiaries, aged 65 years and older (N = 24 009). MEASUREMENTS VI and HI were ascertained by self-report. Dementia status was determined by self-report or diagnosis codes in claims data. Primary outcomes included any inpatient admission over a 2-year period, hospice use over a 2-year period, annual Medicare fee-for-service costs, and total healthcare costs (which included information from Medicare claims data and other self-reported payments). RESULTS Self-reported DSI was present in 30.2% (n = 263/871) of participants with dementia and 17.8% (n = 4112/23 138) of participants without dementia. In multivariable logistic regression models, HI, VI, or DSI was generally associated with increased odds of hospitalization and hospice use regardless of dementia status. In a generalized linear model adjusted for demographics, annual total healthcare costs were greater for those with DSI and dementia compared to those with DSI without dementia ($28 875 vs $3340, respectively). Presence of any sensory impairment was generally associated with higher healthcare costs. In a model adjusted for demographics, Medicaid status, and chronic medical conditions, DSI compared with no sensory impairment was associated with a small, but statistically significant, difference in total healthcare spending in those without dementia ($1151 vs $1056; P < .001) but not in those with dementia ($11 303 vs $10 466; P = .395). CONCLUSION Older adults with sensory and cognitive impairments constitute a particularly prevalent and vulnerable population who are at increased risk of hospitalization and contribute to higher healthcare spending. J Am Geriatr Soc 67:1617-1624, 2019.
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Affiliation(s)
| | - Phillip L. Liu
- Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Richard Sloane
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC
| | - Courtney Van Houtven
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
| | - Carl F. Pieper
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC
| | - Susan Nicole Hastings
- Department of Medicine, Duke University School of Medicine, Durham, NC
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC
- Geriatrics Research Education and Clinical Center, Durham VA Health Care System, Durham, NC
| | - Harvey J. Cohen
- Department of Medicine, Duke University School of Medicine, Durham, NC
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC
| | - Heather E. Whitson
- Department of Medicine, Duke University School of Medicine, Durham, NC
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC
- Geriatrics Research Education and Clinical Center, Durham VA Health Care System, Durham, NC
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC
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13
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Associations among hearing loss, hospitalization, readmission and mortality in older adults: A systematic review. Geriatr Nurs 2019; 40:367-379. [DOI: 10.1016/j.gerinurse.2018.12.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 12/20/2018] [Accepted: 12/21/2018] [Indexed: 12/26/2022]
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14
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Liao H, Zhu Z, Wang H, Rong X, Young CA, Peng Y. Cognitive Performance Concomitant With Vision Acuity Predicts 13-Year Risk for Mortality. Front Aging Neurosci 2019; 11:65. [PMID: 30967772 PMCID: PMC6439522 DOI: 10.3389/fnagi.2019.00065] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 03/06/2019] [Indexed: 01/04/2023] Open
Abstract
Objective: To assess the joint impact of cognitive performance and visual acuity on mortality over 13-year follow-up in a representative US sample. Methods: Data from National Health and Nutrition Examination Survey (NHANES) participants (≥18 years old) were linked with the death record data of the National Death Index (NDI) with mortality follow-up through December 31, 2011. Cognitive performance was evaluated by the Digit Symbol Substitution Test (DSST) and cognitive performance impairment was defined as the DSST score equal to or less than the median value in the study population. Visual impairment (VI) was defined as presenting visual acuity worse than 20/40 in the better-seeing eye. Risks of all-cause and specific-cause mortality were estimated with Cox proportional hazards models after adjusting for confounders. Results: A total of 2,550 participants 60 years and older from two waves of (NHANES, 1999–2000, 2001–2002) were included in the current analysis. Over a median follow-up period of 9.92 years, 952 (35.2%) died of all causes, of whom 239 (23.1%), 224 (24.0%), and 489 (52.9%) died from cardiovascular disease (CVD), cancer, and non-CVD/non-cancer mortality, respectively. Cognitive performance impairment and VI increased the odds for mortality. Co-presence of VI among cognitive impaired elderly persons predicted nearly a threefold increased risk of all-cause mortality [hazard ratios (HRs), 2.74; 95% confidence interval (CI), 2.02–3.70; P < 0.001) and almost a fourfold higher risk of non-CVD/non-cancer mortality (HR, 3.72; 95% CI, 2.30–6.00; P < 0.001) compared to having neither impairment. Conclusion: People aged 60 years and over with poorer cognitive performance were at higher risk of long-term mortality, and were especially vulnerable to further mortality when concomitant with VI. It is informative for clinical implication in terms of early preventive interventions.
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Affiliation(s)
- Huan Liao
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhuoting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Hongxuan Wang
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaoming Rong
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Charlotte Aimee Young
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
| | - Ying Peng
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
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15
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Yu A, Liljas AEM. The relationship between self-reported sensory impairments and psychosocial health in older adults: a 4-year follow-up study using the English Longitudinal Study of Ageing. Public Health 2019; 169:140-148. [PMID: 30904768 DOI: 10.1016/j.puhe.2019.01.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 01/15/2019] [Accepted: 01/31/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To explore cross-sectional and longitudinal relationships between self-reported hearing and vision impairments and self-rated health, quality of life (QoL) and depressive symptoms at 4-year follow-up. STUDY DESIGN The study involved cross-sectional and longitudinal analyses with 4-year follow-up using data from the English Longitudinal Study of Ageing. METHODS Community-dwelling adults (n = 3931) aged ≥50 years from the English Longitudinal Study of Ageing participated in this study. Self-reported hearing and vision were defined as good or poor. Self-rated health was treated as a dichotomous variable (good and poor health). QoL was based on the 19-item Critical Appraisal Skills Programme and treated as a continuous variable (score 0-57). Depressive symptoms were assessed using the eight-item Center for Epidemiologic Studies Depression Scale (CES-D8) and defined as CES-D≥3. Relationships between sensory impairments and self-rated health and depressive symptoms were analysed using logistic regression. Linear regression was used to assess the relationships between sensory impairments and QoL. RESULTS In cross-sectional analyses, both self-reported hearing and vision impairment were positively associated with all outcomes assessed. In longitudinal analyses, self-reported poor hearing and vision were associated with increased risks of poor self-rated health (hearing: odds ratio [OR] 1.65, 95% confidence interval [CI] 1.32, 2.05; vision: OR 1.57, 95% CI 1.16, 2.12) and depressive symptoms (hearing: OR 1.35, 95% CI 1.07, 1.71; vision: OR 1.44, 95% CI 1.09, 1.90) after adjustment for sociodemographic and lifestyle factors, chronic illness, mobility limitations and cognition. Poor hearing and poor vision were not associated with reduced QoL after adjustment for covariates. CONCLUSIONS The findings stress the importance of identifying and addressing sensory impairments in older adults to improve their health and well-being.
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Affiliation(s)
- A Yu
- Research Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, WC1E 6BT, United Kingdom
| | - A E M Liljas
- Research Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, London, NW3 2PF, United Kingdom.
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16
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Bouscaren N, Yildiz H, Dartois L, Vercambre MN, Boutron-Ruault MC. Decline in Instrumental Activities of Daily Living over 4-Year: The Association with Hearing, Visual and Dual Sensory Impairments among Non-Institutionalized Women. J Nutr Health Aging 2019; 23:687-693. [PMID: 31560024 DOI: 10.1007/s12603-019-1231-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Most older adults express the wish to live at home as long as possible, thus autonomy promoting measures are essential. Hearing and visual impairments are common among older people, and they have been consistently associated with functional disability. However, longitudinal data are scarce, notably regarding dual sensory impairments (both in hearing and vision). We aimed at assessing the relationship between hearing, visual, and dual sensory impairments, and subsequent decline in instrumental activities of daily living (IADL). DESIGN Longitudinal. SETTING the French E3N-elderly sub-cohort. PARTICIPANTS 4,010 community-dwelling older women born between 1925 and 1930, and free of IADL limitations in 2006. MEASUREMENTS Hearing and visual impairments were self-reported in 2006. IADLs were evaluated in 2006 and 2010. RESULTS After 4 years of follow-up, 588 women became limited in their IADLs. In logistic regression models adjusted for potential confounders, odds ratios [95% confidence interval] for developing IADL limitations were 1.18 [0.98; 1.41], 1.98 [1.26; 3.11], and 2.61 [1.50; 4.54] for hearing, visual, or both sensory impairments respectively, compared with no sensory impairment at baseline. CONCLUSION Results suggest that among autonomous older women, visual, and to a lesser extent, hearing impairment, have a short-term negative impact on their ability to perform daily activities, with some evidence of a multiplicative effect between sensory impairments. Appropriate evaluation and management of sensory impaired elderly, and more particularly those with dual impairments, may contribute to prevent disability in aging.
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Affiliation(s)
- N Bouscaren
- Marie-Christine Boutron-Ruault, Inserm U1018, Gustave Roussy, 114 rue Edouard Vaillant, Villejuif Cedex 94 805, France, +33 [142116466],
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17
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de la Fuente J, Hjelmborg J, Wod M, de la Torre-Luque A, Caballero FF, Christensen K, Ayuso-Mateos JL. Longitudinal Associations of Sensory and Cognitive Functioning: A Structural Equation Modeling Approach. J Gerontol B Psychol Sci Soc Sci 2018; 74:1308-1316. [DOI: 10.1093/geronb/gby147] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objectives
Although visual and hearing impairments have been found to be associated with cognitive decline in the old age, the mechanism underlying this relationship remains unclear. This study aimed at assessing the predictive role of visual and hearing difficulties on subsequent cognitive functioning.
Method
From the cohort of the first (2002) and fifth waves (2010) of the English Longitudinal Study of Ageing (ELSA), 3,508 individuals aged 60 and older were included in the study. Five self-reported visual and hearing functioning items were used to assess sensory functioning at baseline. Cognition was assessed 8 years later by means of four measured tests covering immediate and delayed recall, verbal fluency, and processing speed. A Multiple Indicators Multiple Causes approach was used to assess the longitudinal associations of visual and hearing functioning with cognitive difficulties. A multigroup longitudinal measurement invariance was used to estimate latent change in cognitive difficulties across groups of participants presenting either visual, hearing, or dual sensory impairment (i.e., those reporting difficulties in both visual and hearing functioning items).
Results
Visual (β = 0.140, p < .001) and hearing (β = 0.115, p < .001) difficulties predicted cognitive difficulties 8 years later. The latent increase in cognitive difficulties was steeper in people with visual impairment (d = 0.52, p < .001), hearing impairment (d = 0.50, p < .001), and dual-sensory impairment (d = 0.68, p < .001) than those non-impaired (d = 0.12, p < .001).
Discussion
Visual and hearing difficulties were identified as predictors of subsequent cognitive decline in the old age. Interventions to prevent visual and hearing difficulties may have a substantial impact to slow down subsequent age-related cognitive decline.
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Affiliation(s)
- Javier de la Fuente
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain
- Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Mental Health, Madrid, Spain
| | - Jacob Hjelmborg
- Unit of Epidemiology, Biostatistics, and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Public Health, The Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
| | - Mette Wod
- Unit of Epidemiology, Biostatistics, and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Public Health, The Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
| | - Alejandro de la Torre-Luque
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain
- Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Mental Health, Madrid, Spain
| | - Francisco Félix Caballero
- Department of Preventive Medicine, Public Health, and Microbiology, Universidad Autónoma de Madrid, Spain
- CIBER of Epidemiology and Public Health, Madrid, Spain
| | - Kaare Christensen
- Unit of Epidemiology, Biostatistics, and Biodemography, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Department of Public Health, The Danish Aging Research Center, University of Southern Denmark, Odense, Denmark
| | - José Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Spain
- Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS Princesa), Madrid, Spain
- Centro de Investigación Biomédica en Red (CIBER) of Mental Health, Madrid, Spain
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18
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Besser J, Stropahl M, Urry E, Launer S. Comorbidities of hearing loss and the implications of multimorbidity for audiological care. Hear Res 2018; 369:3-14. [DOI: 10.1016/j.heares.2018.06.008] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 05/18/2018] [Accepted: 06/14/2018] [Indexed: 12/20/2022]
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19
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Soto-Perez-de-Celis E, Sun CL, Tew WP, Mohile SG, Gajra A, Klepin HD, Owusu C, Gross CP, Muss HB, Lichtman SM, Chapman AE, Cohen HJ, Dale W, Kim H, Fernandes S, Katheria V, Hurria A. Association between patient-reported hearing and visual impairments and functional, psychological, and cognitive status among older adults with cancer. Cancer 2018; 124:3249-3256. [PMID: 29797664 DOI: 10.1002/cncr.31540] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/09/2018] [Accepted: 04/13/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hearing and visual impairments are common among community-dwelling older adults, and are associated with psychological, functional, and cognitive deficits. However, to the authors' knowledge, little is known regarding their prevalence among older patients with cancer. METHODS The current study was a secondary analysis combining 2 prospective cohorts of adults aged ≥65 years with solid tumors who were receiving chemotherapy. The authors assessed the association between patient-reported hearing and/or visual impairment (defined as fair/poor grading by self-report) and physical function, instrumental activities of daily living (IADLs), anxiety, depression, and cognition. Descriptive analyses were conducted to summarize patient and treatment characteristics. One-way analysis of variance and chi-square tests were conducted as appropriate to examine differences between patients with and without sensory impairments. Logistic regression was used to analyze associations between sensory impairments and outcomes. RESULTS Among 750 patients with a median age of 72 years who had solid tumors (29% with breast/gynecological tumors, 28% with lung tumors, and 27% with gastrointestinal tumors), approximately 18% reported hearing impairment alone, 11% reported visual impairment alone, and 7% reported dual sensory impairment. Hearing impairment was associated with IADL dependence (odds ratio [OR], 1.9), depression (OR, 1.6), and anxiety (OR, 1.6). Visual impairment was associated with IADL dependence (OR, 1.9), poor physical function (OR, 1.9), and depression (OR, 2.5). Dual impairment was associated with IADL dependence (OR, 2.8), anxiety (OR, 2.3), depression (OR, 2.5), and cognitive impairment (OR, 3.2). CONCLUSIONS Sensory impairment is common among older adults with cancer. Patients with sensory impairment are more likely to have functional, psychological, and cognitive deficits. Interventions aimed at improving the vision and hearing of older adults with cancer should be studied. Cancer 2018. © 2018 American Cancer Society.
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Affiliation(s)
- Enrique Soto-Perez-de-Celis
- Cancer and Aging Research Program, City of Hope, Duarte, California.,Department of Geriatrics, Salvador Zubiran National Institute of Medical Science and Nutrition, Mexico City, Mexico
| | - Can-Lan Sun
- Cancer and Aging Research Program, City of Hope, Duarte, California
| | - William P Tew
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Supriya Gupta Mohile
- Department of Medicine, University of Rochester Medical Center, Rochester, New York
| | - Ajeet Gajra
- ICON Clinical Research, North Wales, Pennsylvania
| | - Heidi D Klepin
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Cynthia Owusu
- Department of Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Cary Philip Gross
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Hyman B Muss
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Stuart M Lichtman
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andrew E Chapman
- Jefferson Senior Adult Oncology Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Harvey Jay Cohen
- Center for the Study of Aging & Human Development, Duke University Medical Center, Durham, North Carolina
| | - William Dale
- Department of Supportive Care Medicine, City of Hope, Duarte, California
| | - Heeyoung Kim
- Cancer and Aging Research Program, City of Hope, Duarte, California
| | - Simone Fernandes
- Cancer and Aging Research Program, City of Hope, Duarte, California
| | - Vani Katheria
- Cancer and Aging Research Program, City of Hope, Duarte, California
| | - Arti Hurria
- Cancer and Aging Research Program, City of Hope, Duarte, California
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20
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Guthrie DM, Davidson JGS, Williams N, Campos J, Hunter K, Mick P, Orange JB, Pichora-Fuller MK, Phillips NA, Savundranayagam MY, Wittich W. Combined impairments in vision, hearing and cognition are associated with greater levels of functional and communication difficulties than cognitive impairment alone: Analysis of interRAI data for home care and long-term care recipients in Ontario. PLoS One 2018; 13:e0192971. [PMID: 29447253 PMCID: PMC5814012 DOI: 10.1371/journal.pone.0192971] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 02/01/2018] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES The objective of the current study was to understand the added effects of having a sensory impairment (vision and/or hearing impairment) in combination with cognitive impairment with respect to health-related outcomes among older adults (65+ years old) receiving home care or residing in a long-term care (LTC) facility in Ontario, Canada. METHODS Cross-sectional analyses were conducted using existing data collected with one of two interRAI assessments, one for home care (n = 291,824) and one for LTC (n = 110,578). Items in the assessments were used to identify clients with single sensory impairments (e.g., vision only [VI], hearing only [HI]), dual sensory impairment (DSI; i.e., vision and hearing) and those with cognitive impairment (CI). We defined seven mutually exclusive groups based on the presence of single or combined impairments. RESULTS The rate of people having all three impairments (i.e., CI+DSI) was 21.3% in home care and 29.2% in LTC. Across the seven groups, individuals with all three impairments were the most likely to report loneliness, to have a reduction in social engagement, and to experience reduced independence in their activities of daily living (ADLs) and instrumental ADLs (IADLs). Communication challenges were highly prevalent in this group, at 38.0% in home care and 49.2% in LTC. In both care settings, communication difficulties were more common in the CI+DSI group versus the CI-alone group. CONCLUSIONS The presence of combined sensory and cognitive impairments is high among older adults in these two care settings and having all three impairments is associated with higher rates of negative outcomes than the rates for those having CI alone. There is a rising imperative for all health care professionals to recognize the potential presence of hearing, vision and cognitive impairments in those for whom they provide care, to ensure that basic screening occurs and to use those results to inform care plans.
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Affiliation(s)
- Dawn M. Guthrie
- Department of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Jacob G. S. Davidson
- Department of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Nicole Williams
- Department of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Jennifer Campos
- Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
- Department of Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Kathleen Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Medicine/Division of Geriatric Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Paul Mick
- Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Joseph B. Orange
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
| | | | | | | | - Walter Wittich
- School of Optometry, University of Montreal, Montreal, Quebec, Canada
- CRIR/MAB-Mckay Rehabilitation Centre of West-Central Montreal Health, Montreal, Quebec, Canada
- CRIR/Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre, Montreal, Quebec, Canada
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