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      Hearing and vision screening tools for long-term care residents with dementia: protocol for a scoping review

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          Abstract

          Introduction

          Hearing and vision loss among long-term care (LTC) residents with dementia frequently goes unnoticed and untreated. Despite negative consequences for these residents, there is little information available about their sensory abilities and care assessments and practices seldom take these abilities or accessibility needs into account. Without adequate knowledge regarding such sensory loss, it is difficult for LTC staff to determine the level of an individual's residual basic competence for communication and independent functioning. We will conduct a scoping review to identify the screening measures used in research and clinical contexts that test hearing and vision in adults aged over 65 years with dementia, aiming to: (1) provide an overview of hearing and vision screening in older adults with dementia; and (2) evaluate the sensibility of the screening tools.

          Methods and analysis

          This scoping review will be conducted using the framework by Arksey and O'Malley and furthered by methodological enhancements from cited researchers. We will conduct electronic database searches in CENTRAL, CINAHL, EMBASE, MEDLINE and PsycINFO. We will also carry out a ‘grey literature’ search for studies or materials not formally published, both online and through interview discussions with healthcare professionals and research clinicians working in the field. Our aim is to find new and existing hearing and vision screening measures used in research and by clinical professionals of optometry and audiology. Abstracts will be independently reviewed twice for acceptance by a multidisciplinary team of researchers and research clinicians.

          Ethics and dissemination

          This review will inform health professionals working with this growing population. With the review findings, we aim to develop a toolkit and an algorithmic process to select the most appropriate hearing and vision screening assessments for LTC residents with dementia that will facilitate accurate testing and can inform care planning, thereby improving residents’ quality of life.

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          Most cited references26

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          Prevalence of psychiatric disorders among older adults in long-term care homes: a systematic review.

          The population of older adults in long-term care (LTC) is expected to increase considerably in the near future. An understanding of the prevalence of psychiatric disorders in LTC will help in planning mental health services for this population. This study reviews the prevalence of common psychiatric disorders in LTC populations. We searched electronic databases for studies on the prevalence of major psychiatric disorders in LTC using medical subject headings and key words. We only included studies using validated measures for diagnosing psychiatric disorders or psychiatric symptoms. Our review focused on the following psychiatric disorders: dementia, behavioral and psychological symptoms of dementia (BPSD), major depression, depressive symptoms, bipolar disorder, anxiety disorders, schizophrenia, and alcohol use disorders. We also determined the prevalence of psychiatric disorders in the U.S. LTC population using data from the 2004 National Nursing Home Survey (NNHS). A total of 74 studies examining the prevalence of psychiatric disorders and psychological symptoms in LTC populations were identified including 30 studies on the prevalence of dementia, 9 studies on behavioral symptoms in dementia, and 26 studies on depression. Most studies involved few LTC facilities and were conducted in developed countries. Dementia had a median prevalence (58%) in studies while the prevalence of BPSD was 78% among individuals with dementia. The median prevalence of major depressive disorder was 10% while the median prevalence of depressive symptoms was 29% among LTC residents. There were few studies on other psychiatric disorders. Results from the 2004 NNHS were consistent with those in the published literature. Dementia, depression and anxiety disorders are the most common psychiatric disorders among older adults in LTC. Many psychiatric disorders appear to be more prevalent in LTC settings when compared to those observed in community-dwelling older adults. Policy-makers and clinicians should be aware of the common psychiatric disorders in LTC and further research into effective prevention and treatments are required for this growing population.
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            Vision impairment and hearing loss among community-dwelling older Americans: implications for health and functioning.

            We investigated the health, activity, and social participation of people aged 70 years or older with vision impairment, hearing loss, or both. We examined the 1994 Second Supplement on Aging to determine the health and activities of these 3 groups compared with those without sensory loss. We calculated odds ratios and classified variables according to the International Classification of Functioning, Disability and Health framework. Older people with only hearing loss reported disparities in health, activities, and social roles; those with only vision impairment reported greater disparities; and those with both reported the greatest disparities. A hierarchical pattern emerged as impairments predicted consistent disparities in activities and social participation. This population's patterns of health and activities have public health implications.
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              • Article: not found

              Effects of hearing and vision impairments on the Montreal Cognitive Assessment.

              Many standardized measures of cognition include items that must be seen or heard. Nevertheless, it is not uncommon to overlook the possible effects of sensory impairment(s) on test scores. In the current study, we investigated whether sensory impairments could affect performance on a widely used screening tool, the Montreal Cognitive Assessment (MoCA). Three hundred and one older adults (mean age = 71 years) completed the MoCA and also hearing and vision tests. Half of the participants had normal hearing and vision, 38% impaired hearing, 5% impaired vision, and 7% had dual-sensory impairment. More participants with normal sensory acuity passed the MoCA compared to those with sensory loss, even after modifying scores to adjust for sensory factors. The results suggest that cognitive abilities may be underestimated if sensory problems are not considered and that people with sensory loss are at greater risk of cognitive decline.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2016
                26 July 2016
                : 6
                : 7
                : e011945
                Affiliations
                [1 ]Department of Research, Toronto Rehabilitation Institute-University Health Network , Toronto, Ontario, Canada
                [2 ]Lawrence S. Bloomberg Faculty of Nursing, University of Toronto , Ontario, Canada
                [3 ]Department of Speech-Language Pathology, University of Toronto , Toronto, Ontario, Canada
                [4 ]Department of Psychology, University of Toronto , Toronto, Ontario, Canada
                [5 ]Department of Audiology, Baycrest Health Sciences , Toronto, Ontario, Canada
                [6 ]Centre for Sight Enhancement, School of Optometry and Vision Science, University of Waterloo , Waterloo, Ontario, Canada
                [7 ]Department of Kinesiology & Physical Education and Health Sciences, Faculty of Science, Wilfrid Laurier University , Ontario, Canada
                [8 ]School of Optometry, University of Montréal , Montréal, Quebec, Canada
                [9 ]Phonak AG , Stäfa, Switzerland
                [10 ]Department of Psychology, Ryerson University , Toronto, Ontario, Canada
                [11 ]School of Physical and Occupational Therapy, McGill University , Montréal, Quebec, Canada
                [12 ]CRIR/Centre de réadaptation MAB-Mackay du CIUSSS du Centre-Ouest-de-l’Île-de-Montréal. Montréal , Quebec, Canada
                [13 ]CRIR/Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre , Montréal, Quebec, Canada
                Author notes
                [Correspondence to ] Dr Katherine S McGilton; kathy.mcgilton@ 123456uhn.ca
                Article
                bmjopen-2016-011945
                10.1136/bmjopen-2016-011945
                4964241
                27466242
                a3372293-cd7b-4fee-8a97-3b51162a0e68
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 16 March 2016
                : 24 May 2016
                : 30 June 2016
                Categories
                Health Services Research
                Protocol
                1506
                1704
                1698
                1690
                1684

                Medicine
                long term care,optometry,assessment
                Medicine
                long term care, optometry, assessment

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