Relationship between self-reported hearing and vision problems, cognitive decline, depressive symptoms, and life satisfaction in older adults: a retrospective observational study.

BACKGROUND: Sensory impairment in older adults is associated with cognitive decline, elevated depressive symptoms, and low levels of life satisfaction. However, these relationships are usually investigated separately and in pairs. This study examined these relationships comprehensively, for the first time. METHODS: The analysis included 5,658 community-dwelling older adults from the China Health and Retirement Longitudinal Study (aged 50 to 108 years, 52.1% male) who completed the Jorm Informant Questionnaire Cognitive Decline in the Elderly and the Center for Epidemiological Studies-Depression-short form. A questionnaire was used to collect information on hearing, visual status, and life satisfaction. Structural equation modelling was used to examine the direct and indirect relationships between these variables. RESULTS: Self-reported hearing and vision problems are directly associated with cognitive decline and elevated depressive symptoms. In addition, hearing and vision problems are indirectly related to cognitive decline through elevated depressive symptoms. Although hearing and vision problems had no direct effect on life satisfaction, they were indirectly associated with life satisfaction through cognitive decline and depressive symptoms. CONCLUSIONS: This study provides the first epidemiological evidence of the comprehensive relationships between hearing and vision problems, cognitive decline, depressive symptoms, and life satisfaction. When older adults report hearing and/or vision problems, clinicians and caregivers should be aware of the concurrence of declined cognition, elevated depressive symptoms, and compensated life satisfaction. Future studies should examine the causal relationships and potential mechanisms of these relationships.

Self-Reported Vision Loss, Health Status, and Social Participation Among Middle-Aged and Older Adults-Evidence From China.

Social participation is crucial for enhancing senior's well-being and promoting their integration into society. Using nationwide data investigated in China, this study explored the association between self-reported visual impairment, health level, and social participation among Chinese middle-aged old adults. It has been found that (a) the probability and frequency of social participation among middle-aged and older adults with self-reported vision loss were significantly lower than those without vision problems; (b) self-reported vision loss was negatively associated with self-rated health and mental health status, and both were positively associated with social participation; and (c) self-rated health and mental health played a mediating role between vision loss and social participation. The findings suggest that under the framework of active aging, universal vision screening programs and rehabilitation plans for the older adults with visual impairment are exceedingly significant to promote their participation in social activities, thereby enhancing their quality of life.

Assessing the pool activity level (PAL) checklist for use with people with hearing and vision loss.

BACKGROUND: The PAL is a career-completed assessment that indexes cognitive functional ability to inform individualised support. As hearing and vision loss are prevalent, we assessed the PAL for potential bias with hearing or vision impairment. METHODS: We collected PAL responses for 333 adults aged over 60 years in the UK, France, Canada, Greece and Cyprus. All participants had normal cognition based on self-reported status and normal range scores on a cognitive screening test. Using a Kruskal-Wallis test, we compared PAL item response distributions for people with assessed hearing or vision loss compared to those with normal sensory function. RESULTS: There were no differences in response distributions between hearing or vision impaired groups versus those with normal sensory function on any PAL item. CONCLUSION: The PAL reliably indexes cognitive functional ability and may be used to inform support tailored to individual cognitive level amongst older adults with prevalent hearing and vision impairments.

The impact of sensory impairments and eye diseases on cognitive function in elderly Chinese: The mediating effects of social participation.

Background: Sensory impairments and eye diseases increase the risk of cognitive decline, but little is known regarding their influence on cognitive function in elderly Chinese and the underlying mechanisms. We aimed to explore these influence mechanism from the social participation perspective. Methods: We selected 2876 respondents aged ≥60 from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2013, 2015, and 2018. We assessed sensory impairments and eye diseases based on self-reported responses, and evaluated its relation to social participation and cognitive function by fixed-effects regression and mediation effect analysis over a five-year period. Results: Respondents with visual impairment and cataracts had poor memory and mental status. Compared with near visual impairment, distance visual impairment was associated with a 1.7 times higher likelihood of cognitive decline (correlation coefficient (ß) = -0.051; 95% confidence interval (CI) = -0.065, -0.036)). Respondents with hearing impairment had bad memory (ß = -0.046; 95% CI = -0.065, -0.036), but not mental status. Social participation partially mediated the relationships of sensory impairments and cataracts with cognitive function in elderly Chinese. Individuals with sensory impairments affected by limited social participation reported a faster cognitive decline compared to those with eye disease. Conclusions: We found that sensory impairments and eye diseases were negatively associated with cognitive function. Furthermore, sensory impairments and cataracts influence cognitive function partly via social participation. Our results have important theoretical and practical implications and suggests that early interventions for sensory impairments and eye diseases may improve the cognitive function of elderly people.

Prevalence of Mental Ill-Health among Visually Impaired Patients in a Tertiary Institution in Southwestern Nigeria.

BACKGROUND: To study the mental health status of patients with visual impairment in a tertiary institution in Southwestern Nigeria. OBJECTIVES: To determine the mental health status of individuals with loss of vision in Ogbomoso and associated factors. METHODOLOGY: A descriptive cross-sectional study. Questionnaires were administered to obtain information on the socio-demographic characteristics and mental health status. Test for association was done. A total score greater than or equal to 4 out of the 28 items of the General Health Questionnaire was considered a case of mental ill-health. RESULTS: 250 subjects were studied, out of which 126 (50%) were found to have mental ill-health. Statistically significant association was found between age, level of education, occupation, duration of loss of vision, and pattern of loss of vision (p-values < 0.001, 0.020, 0.001, and 0.001 respectively) in bivariate analysis, however, age and pattern of vision loss were not significantly associated with loss of vision in multivariate analysis. Those who lost their vision less than two years from the time of the study had a higher risk of mental health morbidity. Those with sudden vision loss were 3.48 times more likely to have mental health morbidity in bivariate analysis, compared with those with progressive visual loss. CONCLUSION: The prevalence of mental ill-health among people with vision loss is high. Associated factors included level of education, occupation and duration of loss of vision. Predictors of good mental health included younger age group, higher level of education, being employed, longer duration of loss of vision and progressive pattern of vision loss.

CONTEXTE: Étudier l'état de santé mentale des patients atteints de déficience visuelle dans un établissement tertiaire du sud-ouest du Nigeria. OBJECTIFS: Déterminer l'état de santé mentale des personnes souffrant d'une perte de vision à Ogbomoso et les facteurs associés. MÉTHODOLOGIE: Étude descriptive transversale. Des questionnaires ont été administrés pour obtenir des informations sur les caractéristiques sociodémographiques et l'état de santé mentale. Un test d'association a été effectué. Un score total supérieur ou égal à 4 sur les 28 items du General Health Questionnaire a été considéré comme un cas de mauvaise santé mentale. RÉSULTATS: 250 sujets ont été étudiés, dont 126 (50 %) présentaient une mauvaise santé mentale. Une association statistiquement significative a été trouvée entre l'âge, le niveau d'éducation, la profession, la durée de la perte de vision et le type de perte de vision (valeurs p < 0,001, 0,020, 0,001 et 0,001 respectivement) dans l'analyse bivariée, cependant, l'âge et le type de perte de vision n'étaient pas significativement associés à la perte de vision dans l'analyse multivariée. Les personnes ayant perdu la vue moins de deux ans après le début de l'étude présentaient un risque plus élevé de morbidité mentale. Les personnes ayant subi une perte soudaine de la vue étaient 3,48 fois plus susceptibles de souffrir de morbidité mentale dans l'analyse bivariée, par rapport à celles ayant subi une perte progressive de la vue. CONCLUSION: La prévalence de la mauvaise santé mentale chez les personnes souffrant d'une perte de vision est élevée. Les facteurs associés sont le niveau d'éducation, la profession et la durée de la perte de vision. Les facteurs prédictifs d'une bonne santé mentale sont le groupe d'âge le plus jeune, le niveau d'éducation le plus élevé, le fait d'avoir un emploi, la durée la plus longue de la perte de vision et le modèle progressif de la perte de vision. Mots-clés: Déficience visuelle, Mauvaise santé mentale.

Quality of life of caregivers of children with visual impairment: A qualitative approach.

BACKGROUND: Receiving a diagnosis of a child with untreatable visual impairment (VI) may have a negative impact on parents and caregivers, and affect their quality of life (QoL). AIMS: To use a qualitative research approach to determine the impact that caregiving a child with a VI has on the QoL of caregivers in Catalonia (Spain). METHODS: An observational study was designed in which nine parents of children with VI (6 mothers) were recruited following an intentional sampling scheme. In-depth interviews were conducted, and a thematic analysis was performed to identify main themes and subthemes. The QoL domains defined in the questionnaire WHOQoL-BREF guided data interpretation. RESULTS: An overarching theme was defined (the weight on one's shoulders), as well as two main themes (obstacles race and emotional impact) and seven subthemes. QoL was negatively affected by a general lack of knowledge and understanding regarding VI in children and its implications for children and caregivers, whereas social support, gaining knowledge, or cognitive reappraisal had a positive effect. CONCLUSIONS: Caregiving for children with VI affects all QoL domains, resulting in persistent psychological distress. Both administrations and health care providers are encouraged to develop strategies to assist caregivers in their demanding roles.

Correlation between Central Visual Field Defects and Stereopsis in Patients with Early-to-Moderate Visual Field Loss.

PURPOSE: To investigate the association between stereoacuity and the presence of central visual field defects (CVFDs) due to glaucoma. DESIGN: A prospective, cross-sectional cohort study. PARTICIPANTS: Participants with early-to-moderate glaucoma with a visual acuity better than 20/40, less than a 2-line difference in visual acuity between eyes, and 2 reliable Humphrey visual fields (VFs) (24-2 SITA standard) with mean deviation (MD) in the worse eye better than - 12 dB. METHODS: Stereoacuity was measured using the Titmus stereo test. Participants with a significant field defect (P < 0.005) in any 1 of the central 4 points in the 24-2 SITA standard total deviation map in either eye were classified as having a CVFD. Vision-related quality of life (VR-QOL) was measured using 25-item National Eye Institute Visual Function Questionnaire scores. Logistic regression was used to determine the associations between the level of stereoacuity and age, sex, race, glaucoma type, presence of CVFDs, visual acuity, contrast sensitivity, and VF MD. MAIN OUTCOME MEASURES: Stereoacuity in the CVFD and non-CVFD groups. RESULTS: Sixty-five participants met the inclusion criteria. The mean age of the participants was 64.3 ± 8.0 years, and 64.6% were women. The median stereoacuity was 60 arc seconds (interquartile range [IQR], 40-120 arc seconds). Forty-two (65%) patients had CVFDs, and 23 (35%) patients did not. The median stereoacuity of the CVFD group was worse than that of the non-CVFD group (60 arc seconds [IQR, 50-140 arc seconds] vs. 40 arc seconds [IQR, 40-80 arc seconds], respectively; P = 0.001). The non-CVFD group had a higher percentage of participants with normal stereopsis than the non-CVFD group (61% vs. 21%, respectively; P = 0.001). A multivariable analysis found that the presence of CVFDs was associated with worse stereopsis levels (odds ratio, 4.49; P = 0.021). The CVFD group had a lower Visual Functioning Questionnaire-25 (VFQ-25) composite score (84.0 vs. 91.4; P = 0.004) and lower VFQ-25 subscale scores for general vision, near activities, and mental health (P < 0.05). CONCLUSIONS: Central visual field defects were associated with increased odds of poor stereoacuity in patients with early-to-moderate glaucomatous VF loss. Specifically, patients without CVFDs are more likely to have normal stereopsis and higher VR-QOL than those with CVFDs. Patients with CVFDs should be counseled regarding how depth perception difficulties may affect daily living. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

The Effect of Self-Reported Visual Impairment and Sleep on Cognitive Decline: Results of the Hispanic Community Health Study/Study of Latinos.

BACKGROUND: Visual impairment could worsen sleep/wake disorders and cognitive decline. OBJECTIVE: To examine interrelations among self-reported visual impairment, sleep, and cognitive decline in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Miami-site. METHOD: HCHS/SOL Miami-site participants ages 45-74 years (n = 665) at Visit-1, who returned for cognitive test 7-years later (SOL-INCA). Participants completed the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ), validated sleep questionnaires and test for obstructive sleep apnea (OSA) at Visit-1. We obtained verbal episodic learning and memory, verbal fluency, processing speed, and executive functioning at Visit-1 and at SOL-INCA. Processing speed/executive functioning were added to SOL-INCA. We examined global cognition and change using a regression-based reliable change index, adjusting for the time lapse between Visit-1 and SOL-INCA. We used regression models to test whether 1) persons with OSA, self-reported sleep duration, insomnia, and sleepiness have an increased risk for visual impairment, 2a) visual impairment is associated with worse cognitive function and/or decline, and 2b) sleep disorders attenuate these associations. RESULT: Sleepiness (ß= 0.04; p < 0.01) and insomnia (ß= 0.04; p < 0.001) were cross-sectionally associated with visual impairment, adjusting for sociodemographic characteristics, behavioral factors, acculturation, and health conditions. Visual impairment was associated with lower global cognitive function at Visit-1 (ß= -0.16; p < 0.001) and on average 7-years later (ß= -0.18; p < 0.001). Visual impairment was also associated with a change in verbal fluency (ß= -0.17; p < 0.01). OSA, self-reported sleep duration, insomnia, and sleepiness did not attenuate any of the associations. CONCLUSION: Self-reported visual impairment was independently associated with worse cognitive function and decline.

What do individuals with visual impairment need and want from a dialogue-based digital assistant?

CLINICAL SIGNIFICANCE: Optometrists are well-placed to provide helpful advice and guidance to patients with visual impairment but may not know how best to do this. The availability of a reliable and comprehensive conversational agent to which patients could be directed would be a valuable supplement to clinical intervention. BACKGROUND: The Artificial Intelligence in Visual Impairment (AIVI) Study is a proof-of-concept study to investigate whether ongoing information support for people with visual impairment (VI) can be provided by a dialogue-based digital assistant. The phase of the AIVI Study reported here explored the different dimensions of the information-seeking behaviour of individuals with VI: in particular, their need for information, the methods for obtaining it at present, and their views on the use of a digital assistant. METHODS: Qualitative data were collected from 120 UK-resident adults who responded to an online survey who were either visually impaired (86.7%), a carer or family member of someone with VI (5.8%), or a professional involved in the support of those with VI (7.5%). In addition, 10 in-depth 1:1 semi-structured interviews explored opinions in more detail. Thematic analysis was used to analyse the findings. RESULTS: Analysis of information needs identified 7 major themes: ocular condition; equipment, technology and adaptations; daily activities; registration; finance/employment; emotional support; and support for the carer. Participants used a wide variety of methods to access information from many sources and explained the barriers to access. Participants accepted the merit of a dialogue system aiding in a goal-directed search for specific information, but expressed reservations about its abilities in other areas, such as providing emotional support. CONCLUSIONS: Participants highlighted potential benefits, limitations, and requirements in using a digital assistant to access information about VI. These findings will inform the design of dialogue systems for populations with VI.

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

PURPOSE: Hearing and vision impairment are prevalent chronic conditions associated with poorer mental health. Limitations of in-person contacts during COVID-19-related lockdown measures may affect those with sensory impairments more severely exacerbating mental health problems. We aimed to determine whether hearing and/or visual impairment were associated with more psychological distress during a time of lockdown measures in Spring/Summer 2020 in Wisconsin. METHODS: We included 1341(64% women, aged 20-92 years) Survey of the Health of Wisconsin COVID-19 survey participants (May 2020-July,2020). We assessed self-reported current mental health and well-being and vision and hearing impairment. Logistic regression models with sensory impairments as determinants and mental health outcomes were adjusted for age, gender, race, education, heart disease, hypertension, hyperlipidemia, and diabetes. RESULTS: Vision impairment was associated with increased odds of generalized anxiety disorder (odds ratio = 2.10; 95% confidence interval = 1.32-3.29) and depressive symptoms (2.57;1.58-4.11), greater likelihood to report loneliness (1.65;1.00-2.64) and hopelessness (1.45;1.01-2.08). Hearing impaired individuals reported more loneliness (1.80;1.05-2.98) and hopelessness (1.42;0.99-2.03). Exploratory analyses revealed that sensory impaired individuals less often chose walking as a coping strategy during the pandemic. CONCLUSIONS: Individuals with sensory impairment may represent a particularly vulnerable population during the COVID-19 pandemic. Future research should determine underlying reasons and interventions to mitigate this populations' disadvantages.

Social Networks May Shape Visually Impaired Older Adults' Occupational Engagement: A Narrative Inquiry.

Age-related vision loss (ARVL) has been shown to interfere with older adults' occupational engagement. The primary purpose was to examine the role social networks play in facilitating/constraining engagement in desired occupations for older adults with ARVL. This study adopted a constructivist narrative methodology. Five older adults, ≥ 60 years of age with ARVL, participated in three virtual interviews, which were coded using thematic analysis. Three overarching themes were identified: (a) Diverse Social Networks Fulfill Different Occupational and Psychosocial Needs, (b) Retaining a Sense of Independence through Seeking Reciprocity in Social Relationships, and (c) Community Mobility and Technology Support as Essential for Preserving Social Relationships. Findings broaden understandings of how informal/formal social networks are involved in shaping visually-impaired older adults' adaptation to ARVL and related occupational changes. Findings may help improve the quality and delivery of low-vision rehabilitation services to optimize their contribution to occupational engagement.

The effects of simulated and actual visual impairment on the Montreal Cognitive Assessment.

Many cognitive assessments include a visual component; however, adults may experience a decline in visual acuity with age. Scores on cognitive assessments of adults with visual impairments are typically lower than adults with normal vision, however, it is unclear if these lower scores are a consequence of cognitive or visual impairment. We measured the impact of simulated visual impairment on a cognitive screening measure. Undergraduate students were administered the Montreal Cognitive Assessment (MoCA) under three vision conditions (20/20, simulated 20/80, simulated 20/200). We found a main effect of vision condition on test performance such that there is a statistically significant difference between scores on the 20/20 and 20/80 conditions and 20/200. However, no differences were observed between 20/80 and 20/200. Participants' performance decreased with simulated impairments. A secondary between-subject analysis was conducted on a sample of older adults with and without vision impairment; no differences were found.

Association between vision impairment and depression: a 9-year, longitudinal, nationwide, population-based cohort study in South Korea.

BACKGROUND/AIMS: Vision impairment (VI) increases the risk of various comorbidities, including depression. However, the relationship between depression and VI is unclear, and existing findings are inconsistent. We therefore investigated the risk of depression in adults before and after their registration as visually impaired. METHODS: In this longitudinal, nationwide, retrospective cohort study, 131 434 patients (aged ≥18 years) with newly registered VI during 2005-2013 were evaluated using the Korean National Health Insurance Service database. Using 1:1 propensity score matching, randomly selected patients (control group) were compared with patients with VI (patient group) according to age, sex, residential area and household income. Each patient was tracked from 3 years before and 5 years after registration. The risk of depression before and after VI registration was evaluated using a conditional logistic regression model. RESULTS: The risk of depression gradually increased from 3 years before registration (OR, 1.186; 95% CI 1.089 to 1.290), then peaked at the time of registration (OR, 1.925; 95% CI 1.788 to 2.073), and then gradually decreased until 5 years after registration (OR, 1.128; 95% CI 1.046 to 1.216). Male patients, those with severe VI and those aged 18-29 years had a higher risk of depression. CONCLUSIONS: Patients with VI had an increased risk of depression from 3 years before to 5 years after registration. Significant risk factors included severity, male sex and younger age. Thus, public mental health services are necessary to provide appropriate support and interventions to people before and after registration as visually impaired.

Concurrent hearing and vision impairment and 8-year memory decline in community-dwelling older adults.

BACKGROUND: Hearing and vision impairments are risk factors for cognitive decline; less is known about dual sensory impairment. This study quantifies the association between dual sensory impairment and 8-year change in memory among older adults. METHODS: Data (N = 5552) were from the National Health and Aging Trends Study. Memory (immediate/delayed word recall, subjective memory) was measured annually (2011 to 2019). Hearing and vision impairments were measured by self-report. Association between dual sensory impairment and 8-year change in memory was assessed using multivariate linear mixed effect models and generalized logistic mixed models. RESULTS: Rate of memory decline was most accelerated among participants with dual sensory impairment. For example, 8-year decline in delayed word recall was -1.03 (95% confidene interval: -1.29, -0.77) for dual sensory impairment versus -0.79 (-0.92, -0.67) for single and -0.56 (-0.63, -0.48) for no impairment. CONCLUSION: Older adults with dual sensory impairment may be at particularly higher risk for cognitive decline.

Can Digital Communication Protect Against Depression for Older Adults With Hearing and Vision Impairment During COVID-19?

OBJECTIVES: During social isolation imposed by the coronavirus disease 2019 (COVID-19) pandemic, older adults with impaired hearing and vision potentially experienced more communication challenges, increasing their risk for poor mental health. Digital communication (e.g., video calls, e-mail/text/social media) may alleviate in-person isolation and protect against depression. We addressed this question using data from the National Social Life, Health, and Aging Project, a nationally representative panel study of community-dwelling older adults. METHOD: Two thousand five hundred fifty-eight adults aged 55 and older comprised the analytic sample. Interviewer rating at baseline (2015-2016) classified those with vision impairment (VI) or hearing impairment (HI). Olfactory impairment (OI) was measured by objective testing. During COVID-19 (2020-2021), respondents reported how often they contacted nonhousehold family or friends and whether this was by phone, e-mail/text/social media, video, or in-person. They also quantified the frequency of depressive feelings. RESULTS: Older adults with VI or HI but not OI at baseline were significantly less likely to report regular use of video calling and e-mail/text/social media during the pandemic compared to those without impairment. Sensory impairments did not affect the frequency of phone or in-person communication. Adults with VI or HI were more likely to experience frequent depressive feelings during COVID-19. Video calls mitigated this negative effect of VI- and HI-associated depressive feelings in a dose-dependent manner. DISCUSSION: Among communication modalities, video calling had a protective effect against depressive feelings for people with sensory impairment during social isolation. Improving access to and usability of video communication for older adults with sensory impairment could be a strategy to improve their mental health.

Self-Reported Dual Sensory Impairment and Subjective Cognitive Complaints Among Older Adults in the 2019 National Health Interview Survey.

PURPOSE: Subjective cognitive complaints (SCCs) are associated with poor quality of life, important for clinical care planning and management, and may predict dementia diagnosis. Dual sensory impairment (DSI) is a risk factor for dementia, but whether DSI is associated with SCCs is unknown. We evaluated whether self-reported DSI is associated with SCCs. METHOD: We performed a cross-sectional analysis of 9,899 community-dwelling respondents aged 60+ years without dementia or depression in the 2019 National Health Interview Survey. Participants self-reported difficulty remembering or concentrating, seeing even when wearing corrective lenses, and hearing even when using a hearing aid. We defined SCCs and sensory impairment for each mode as reporting at least some difficulty. We categorized sensory impairment into no sensory impairment, vision impairment only, hearing impairment only, and DSI. We then estimated weighted prevalence ratios (PRs) of SCCs by impairment category. RESULTS: After weighting (9,899 participants representing a weighted n = 59,261,749), 12% of participants reported vision impairment only, 19% reported hearing impairment only, and 7% reported DSI. Relative to no impairment, after adjustment for potential confounders, vision impairment (PR = 2.07; 95% confidence interval [CI] [1.79, 2.39]), hearing impairment (PR = 2.26; 95% CI [2.00, 2.55]), and DSI (PR = 3.21; 95% CI [2.83, 3.63]) were associated with an increased prevalence of SCCs. CONCLUSIONS: In this nationally representative survey of older Americans, DSI was associated with a threefold increased prevalence of SCCs. Although cross-sectional, these data underscore the importance of assessing multiple impairments as exposures when studying subjective cognition in older adults. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21498711.

Successful Aging in Assisted Living: The Importance of Near Visual Acuity.

Successful aging among independent community-dwelling older adults and those in residential settings is paramount to aging in place. The purpose of the current study was to explore how sensory, cognitive, and functional impairments affect successful aging in assisted living (AL) settings. Vision compromise was noted for near visual acuity (NVA) (14.3%) and distance visual acuity (11.9%). More than one third (34.1%) of participants screened positive for compromised cognition, functional impairment was present in 48.9%, and successful aging was present in 55.7%. NVA and functional status were related to successful aging (r = 0.328, p = 0.004; r = 0.341, p = 0.002, respectively), and explained 9.3% of the variance in successful aging (F[2, 75] = 3.83, p = 0.026). Having a lower NVA score (ß = -0.277, p = 0.021) uniquely affected the successful aging score. Interventions supporting AL residents' sensory and cognitive health should be a priority to improve successful aging. [Journal of Gerontological Nursing, 48(9), 8-14.].

A Newly Identified Impairment in Both Vision and Hearing Increases the Risk of Deterioration in Both Communication and Cognitive Performance.

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.

Association of Dual Sensory Impairment with Cognitive Decline in Older Adults.

INTRODUCTION: The prevalence of hearing and visual impairment (HI and VI) and dual sensory impairment (DSI), which is a combination of both, is increasing as the population ages. These sensory impairments are expected to increase the cognitive load of information processing from hearing and vision and impair appropriate cognitive processing. Although an association between DSI and cognitive decline has been reported, a more detailed study of the effects on each cognitive domain is required. This study aimed to investigate the prevalence of self-reported sensory impairment in community-dwelling older adults and to examine the impact of DSI on the severity of mild cognitive impairment (MCI) and on each cognitive domain (memory, attention, executive function, and processing speed). METHODS: The participants were recruited from a sub-cohort of the National Center for Geriatric Gerontology-Study on Geriatric Syndromes (NCGG-SGS) conducted by the National Center for Geriatrics and Gerontology. We included 4,471 community-dwelling older adults (age: 75.9 ± 4.3 years; females: 52.3%) who fulfilled the inclusion criteria. The HI and VI were identified using a self-report questionnaire. Cognitive and other parameters were also assessed by trained staff. Logistic regression analysis was used to evaluate the relationship between the presence of HI and VI and the severity of MCI, and functional decline in each cognitive domain. RESULTS: DSI was identified in 11.4% of community-dwelling older adults. Regarding sensory impairment and MCI severity, the odds ratio (OR) for single-domain MCI was significantly higher in VI (OR: 1.31; 95% CI: 1.06-1.61), and the OR for multiple-domain MCI was significantly higher in DSI (OR: 1.58; 95% CI: 1.10-2.29). In relation to the four cognitive domains, ORs for impaired executive function were higher for VI and DSI (VI, OR: 1.37; 95% CI: 1.09-1.72. DSI, OR: 1.39; 95% CI: 1.06-1.81). DSI also exhibited a higher odds ratio for reduced processing speed (OR: 2.03; 95% CI: 1.42-2.91). DISCUSSION/CONCLUSION: DSI is predicted to increase as the population ages and is associated with various health problems. Further, DSI has been reported to decrease quality of life, which needed to establish appropriate treatment and prevention measures.

Quality of life in children with glaucoma: a qualitative interview study in Australia.

OBJECTIVE: Childhood glaucoma is a chronic vision-threatening condition that may significantly impact an individual's psychosocial well-being. There is a paucity of literature investigating the quality of life (QoL) in children with glaucoma. The aim of this study was to investigate and report on the QoL issues encountered by children with glaucoma. DESIGN: This is a qualitative interview study. Data were collected through semistructured interviews. NVivo V.12 software (QSR International Pty Ltd, Melbourne, Australia) was used to analyse and code data to identify QoL themes. The prominence of QoL themes was determined by the number of children who raised issues connected to the corresponding theme. SETTING: Interviews were conducted via telephone or videoconferencing between April 2020 and July 2021. PARTICIPANTS: Eighteen children with glaucoma, aged 8-17 years, who resided in Australia, were recruited from the Australian and New Zealand Registry of Advanced Glaucoma. RESULTS: Median child age was 12.1 years (IQR: 9.7-14.5 years) and 33% were female. Seven QoL themes were identified: 'coping', 'inconveniences' and 'emotional well-being' were more prominent themes than 'symptoms', 'ocular health concerns', 'social well-being' and 'autonomy'. Adaptive coping strategies included resilience throughout clinical examinations and establishing positive relationships with ophthalmologists. These minimised inconveniences related to clinic waiting times and pupillary dilatation. External to the clinical setting, children often dissociated from their glaucoma but struggled with glare symptoms and feeling misunderstood by fellow peers. Older children aged 13-17 years commonly disengaged from their glaucoma care and expressed an unwillingness to attend ophthalmic appointments. Older children further raised issues with career options, obtaining a driver's licence and family planning under the theme of autonomy. CONCLUSIONS: The psychosocial impact of childhood glaucoma extends beyond the clinical environment and was minimised using coping strategies. Older children may require additional social and ophthalmic support as they transition into adulthood.