Dataset Information

Concurrent vision and hearing impairment associated with cognitive dysfunction in a population aged 85+ years: the Ural Very Old Study.

ABSTRACT:

Objective

To assess the prevalence of vision impairment, hearing impairment and dual sensory impairment (DSI) as combination of vision and hearing impairment, in association with cognitive dysfunction in a population aged 85+ years.

Methods

The cross-sectional population-based Ural Very Old Study, conducted in rural and urban Bashkortostan, Russia, between 2017 and 2020, included a detailed ocular and systemic examination with assessment of moderate to severe vision impairment (MSVI)/blindness (best-corrected visual acuity <6/18), moderate to severe hearing loss (MSHL) and cognitive function.

Setting

A rural and urban area in Bashkortostan, Russia.

Participants

Out of 1882 eligible individuals aged 85+ years, 1526 (81.1%) individuals participated.

Primary and secondary outcome measures

Prevalence of vision, hearing and DSI and cognitive dysfunction.

Results

The study included 731 (47.9%) individuals (mean age 88.1±2.7 years; median 87 years, range 85-98 years) with measurements of MSVI/blindness, MSHL and cognitive function. The prevalence of MSVI/blindness, MSHL, DSI and dementia were 51.8% (95% CI 48.2% to 55.5%), 33.1% (95% CI 29.7% to 36.5%), 20.5% (95% CI 17.8% to 23.5%) and 48.2% (95% CI 44.5% to 51.8%), respectively. Lower cognitive function score was associated with lower visual acuity (p<0.001) and higher hearing loss score (p=0.03), after adjusting for older age (p=0.001), rural region of habitation (p=0.003), lower educational level (p<0.001) and higher depression score (p<0.001). Higher dementia prevalence was associated with higher MSHL prevalence (OR 2.18 95% CI 1.59 to 2.98; p<0.001), higher MSVI/blindness prevalence (OR 2.09, 95% CI 1.55 to 2.81; p<0.001) and higher DSI prevalence (OR 2.80, 95% CI 1.92 to 4.07; p<0.001).

Conclusions

In this very old, multiethnic population from Russia, DSI (prevalence 20.5%), as compared with hearing impairment (OR 2.18) and vision impairment alone (OR 2.09), had a stronger association (OR 2.80) with dementia. The findings show the importance of hearing and vision impairment, in particular their combined occurrence, for dementia prevalence in an old population.

SUBMITTER: Bikbov MM

PROVIDER: S-EPMC9045115 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Publications

Concurrent vision and hearing impairment associated with cognitive dysfunction in a population aged 85+ years: the Ural Very Old Study.

Bikbov Mukharram M MM Kazakbaeva Gyulli M GM Rakhimova Ellina M EM Rusakova Iuliia A IA Fakhretdinova Albina A AA Tuliakova Azaliia M AM Panda-Jonas Songhomitra S Bolshakova Natalia I NI Safiullina Kamilia R KR Gizzatov Ainur V AV Ponomarev Ildar P IP Yakupova Dilya F DF Baymukhametov Nail E NE Nikitin Nikolay A NA Jonas Jost B JB

BMJ open 20220426 4

<h4>Objective</h4>To assess the prevalence of vision impairment, hearing impairment and dual sensory impairment (DSI) as combination of vision and hearing impairment, in association with cognitive dysfunction in a population aged 85+ years.<h4>Methods</h4>The cross-sectional population-based Ural Very Old Study, conducted in rural and urban Bashkortostan, Russia, between 2017 and 2020, included a detailed ocular and systemic examination with assessment of moderate to severe vision impairment (MS ...[more]

PMID: 35473730

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Project description:Introduction: As the prevalence of age-related sensory impairment increases, more evidence emerges on the association between uni-sensory and cognitive impairment (CI) in older adults. However, the link between CI and concurrent hearing and vision impairment (referred to as dual sensory impairment/DSI) is not well-understood, and this combined effect may be additive or multiplicative. Moreover, the existing evidence on CI in older adults with DSI is scattered and limited. Through this systematic scoping review, we aim to map existing evidence on CI in older adults with DSI, and to summarize what is known about the prevalence, incidence and risk factors of CI, and tools used to screen or assess CI in older adults with DSI. Methods and Analysis: We will use the Joanna Briggs Institute framework to perform the review. Eleven databases [MEDLINE, CINAHL/EBSCO, EMBASE, Mednar, WorldWideScience, PsycEXTRA, OAIster, OpenGrey (SIGLE), Global Health, PsycINFO, and Web of Science] and clinical trial registries (ISRCTN Registry, WHO ICTRP, and ClinicalTrials.gov) will be searched. Study selection will be completed using Covidence, and data will be extracted using an a priori data extraction tool. To be included, studies had to be peer-reviewed, had older adults with DSI as the focal population, and are related to CI. Data will be presented using a narrative summary with emphasis on implications for future research and practice. Discussion: Reliable cognitive screening is of the utmost importance for prevention and treatment of CI within DSI population. The study findings will have significant implications for health services delivery and policy research. The summarized findings on the prevalence, incidence, associated risk factors, and CI screening and assessment tools will inform geriatric care. The review will also document knowledge gaps on CI in the DSI population and identify areas of interest for future studies. Ethics and Dissemination: The scoping study, being a review of existing documents, does not require ethics approval. The findings will be disseminated with relevant stakeholders using knowledge translation activities such as scientific presentations and publications. We intend to use the findings to conduct a Delphi study to evaluate which CI tools are suitable for older population with DSI.

Project description:Background and objectivesA global report estimates up to 2% of the world population experience concurrent hearing and vision impairment (dual sensory impairment [DSI]). Older adults with DSI are often frequent users of health care, yet the evidence is limited to inform care delivery for this population. This systematic review aimed to synthesize evidence on tools and strategies for screening, assessment, and interventions that promote a continuum of care for older adults with DSI.Research design and methodsThe review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews. Electronic databases (CINAHL, Embase, MEDLINE, PsycINFO, Cochrane Library, Global Health, and Web of Science) and clinical trial registries (ISRCTN Registry, WHO ICTRP, and ClinicalTrials.gov) were searched. The quality appraisal was performed using the Mixed Methods Appraisal Tool.ResultsOf 4,775 identified references, 28 records were selected. The review identified 7 tools and 7 strategies for DSI-specific screening, assessments, and/or interventions. Some of the most promising tools were the interRAI Community Health Assessment with deafblind supplement, adapted Montreal Cognitive Assessment, and the Severe Dual Sensory Loss screening tool. Useful strategies included the use of alternative forms of communication, assistive devices or technology, education and training for service providers, and training of older adults on the use and maintenance of assistive aids/technology. However, quality appraisal indicated a need for more robust evidence to inform clinical practice.Discussion and implicationsReviewed evidence pinpointed the need for training for health care providers on DSI-specific challenges and supports and the use of integrated multidisciplinary care for older adults. Future studies need to explore the development and evaluation of tools and interventions to improve the continuum of care for this group. Systematic Review Registration: PROSPERO registration # CRD42020180545.

Project description:PurposeTo examine prevalence and associated factors of the metabolic syndrome (MS) in populations in Russia.MethodsTwo population-based studies (Ural Eye and Medical Study (UEMS), Ural Very Old Study (UVOS)) were conducted in rural and urban regions in Bashkortostan/Russia and included participants aged 40+ years and 85+ years, respectively.ResultsOut of 5895 UEMS participants, 1572 individuals had MS (prevalence:26.7%; 95% confidence interval (CI):25.5,27.8). The criteria of waist circumference, blood pressure, hyperglycemia, serum high-density lipoprotein concentration and serum triglyceride concentration were fulfilled by 4269 (72.4%; 95%CI:71.3,73.6), 3168 (53.7%; 95%CI:52.5,55.1), 1375 (23.3%; 95%CI:22.4,24.6), 712 (13.3%; 95%CI:12.4,14.2), and 1527 (28.6%; 95%CI:27.4,29.8) individuals, respectively. Higher MS prevalence was associated with older age (odds ratio (OR):1.03; 95%CI:1.02,1.04;P < 0.001), female sex (OR:1.93; 95%CI:1.51,2.47;P < 0.001), higher body height (OR:1.03; 95%CI:1.01,1.04;P < 0.001), Russian ethnicity (OR:1.38; 95%CI:1.13,1.70;P = 0.002), lower ankle-brachial index (OR:0.19; 95%CI:0.11,0.30;P < 0.001), higher prevalence of lower backache (OR:1.29; 95%CI:1.08,1.52;P = 0.004), cardiovascular disease (OR:2.32; 95%CI:1.92,2.78;P < 0.001) and thyroid disease (OR:1.41; 95%CI:1.04,1.92;P = 0.03), lower international normalized ratio (OR:0.55; 95%CI:0.32,0.95;P = 0.03), lower prevalence of current smoking (OR:0.67; 95%CI:0.50,0.89;P = 0.006), and higher prevalence of alcohol consumption (OR:1.35; 95%CI:1.11,1.64;P = 0.003). Out of 1124 UVOS participants (age:88.2 ± 2.7 years; range:85-100 years), MS was present in 485 individuals (prevalence:43.1%; 95%CI:40.3,46.1). The criteria of waist circumference, blood pressure, hyperglycemia, serum high-density lipoprotein concentration and serum triglyceride concentration were fulfilled by 853 (75.9%; 95%CI:73.4,78.4), 1057 (94.0%; 95%CI:92.7,95.4), 320 (26.9%; 95%CI:24.3,29.5), 525 (46.7%; 95%CI:43.8,49.6), and 337 (30.0%; 95%CI:27.3,32.7, individuals, respectively. Higher MS prevalence was associated with female sex (OR:2.30; 95%CI:1.72,3.09;P < 0.001) and higher serum concentration of aspartate transaminase (OR:1.02; 95%CI:1.01,1.03;P = 0.007).ConclusionsMS is common in Russia, increases with age up to about 70 years and then plateaus, is more common in women, and differs in its associated factors between middle-aged and very old populations.

Project description:ImportanceImpairments in vision or hearing are common and have been independently linked to higher risk of dementia in older adults. There is a limited understanding of the prevalence of concurrent functional vision and hearing impairment (dual sensory impairment) and its contribution to dementia risk.ObjectiveTo examine the age-specific prevalence of functional dual sensory impairment among older adults, and to investigate the cross-sectional and 7-year longitudinal associations between functional dual sensory impairment and dementia.Design, setting, and participantsThis cohort study of 7562 older adults used data from the US National Health and Aging Trends Study (NHATS), a nationally representative cohort study of community-dwelling, Medicare beneficiaries aged 65 years and older in the US. Participants in the study with complete data on hearing, vision, and dementia were included in analysis. Data were collected between 2011 and 2018, and between March 2018 and May 2020.ExposuresSelf-reported functional sensory impairments (ie, no sensory impairment, functional vision impairment only, functional hearing impairment only, and functional dual sensory impairment).Main outcomes and measuresAge-specific prevalence of functional sensory impairments was calculated. Generalized linear regression with a complementary log-log link and a discrete time proportional hazards model with a complementary log-log link were used to assess the cross-sectional and 7-year longitudinal hazard of dementia.ResultsOf 7562 participants, 3073 (40.7%) were ages 80 years or older and 4411 (58.3%) were women. Overall, 5.4% (95% CI, 4.7%-6.1%) of participants reported functional vision impairment only, 18.9% (95% CI, 18.9%-17.8%) reported functional hearing impairment only, and 3.1% (95% CI, 2.7%-3.5%) reported functional dual sensory impairment (prevalence estimates are weighted). Participants reporting sensory impairments were older (no impairment: age ≥90 years, 2.12% [95% CI, 1.79%-2.46%] vs functional dual sensory impairment: age ≥90 years, 20.06% [95% CI, 16.02%-24.10%]), had lower education (no impairment: <high school, 19.05% [95% CI, 17.27%-20.83%] vs functional dual sensory impairment: <high school, 46.15% [95% CI, 38.38%-53.92%]), and greater disease burden (eg, heart disease: no impairment, 15.30% [95% CI, 14.04%-16.55%] vs functional dual sensory impairment, 25.49% [95% CI, 19.96%-31.02%]). Compared with no impairment, functional vision impairment (adjusted hazard ratio [aHR], 1.89; 95% CI, 1.57-2.28), functional hearing impairment (aHR, 1.14; 95% CI, 1.00-1.31), and functional dual sensory impairment (aHR, 2.00; 95% CI, 1.57-2.53) were associated with a higher cross-sectional hazard of dementia. Over 7 years, functional vision impairment (aHR, 1.40; 95% CI, 1.12-1.74), functional hearing impairment (aHR, 1.09; 95% CI, 0.95-1.24), and functional dual sensory impairment (aHR, 1.50; 95% CI, 1.12-2.02) were associated with a higher hazard of incident dementia compared with no impairment.Conclusions and relevanceIn this cohort study of US Medicare beneficiaries, dual sensory impairment was prevalent in older adults and associated with increased risk of dementia. These findings suggest that sensory rehabilitative interventions for multiple impairments may be an additional resource in efforts to reduce dementia risk.

Dataset Information

Concurrent vision and hearing impairment associated with cognitive dysfunction in a population aged 85+ years: the Ural Very Old Study.

Objective

Methods

Setting

Participants

Primary and secondary outcome measures

Results

Conclusions

Publications

Concurrent vision and hearing impairment associated with cognitive dysfunction in a population aged 85+ years: the Ural Very Old Study.

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