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• W2019812916 abstract "To the Editor: Various studies have described a significant increase in the prevalence of impaired vision and hearing with age.1-4 Diminished vision has been associated with disability in activities of daily living (ADLs)5-8 and in instrumental ADLs (IADLs),6-9 and an association between hearing impairment and dependency in IADL functions has been found in at least two studies.7, 9 Despite our knowledge about single sensory impairment, little is known about the double sensory impairment and its association with functional dependency. Keller et al.7 noted that subjects seen in outpatient geriatric clinic with dual sensory impairment had mean IADL and ADL scores significantly lower than those with no impairment, and dual impairment had a greater effect on function than single sensory impairment.7 In this population-based study, we wanted to determine the age-adjusted effect of functional visual and hearing impairment, especially double sensory impairment, to ADL. This study was part of the population-based Kuopio 75+ study in Finland. Of the 700 persons (aged ≥75) eligible, 601 (85.9%) participated in the standardized interview and geriatric assessment between January 1998 and January 1999. Fifteen (2.1%) died before being seen, 79 (11.3%) refused to participate, and five (0.7%) could not be contacted at all. Because of their inability for adequate cooperation in the investigative procedures, 113 demented persons were excluded from the sensory study. Thus the sensory study group included 488 persons. The ADL functions were evaluated using the Barthel Index and the IADL functions using the IADL scale of Lawton and Brody. The total score of the Barthel Index ranges from 0 to 100 points (help needed in all activities to independent in all activities), and the IADL scale ranges from 0 to 8 points, with 8 points meaning that no help is need. Functional hearing impairment was registered if the interviewed person had a clear difficulty in conversation due to poor hearing acuity observed by the nurse, the person expressed that his or her main health problem was difficulty in hearing, or the person had earlier been ordered a hearing aid. The visual examination consisted of an assessment of binocular visual acuity for distance (Snellen charts with E-letters) and near (the reading charts) corrected with the patient's spectacles. Functional visual impairment was registered if visual acuity was less than 20/60 by Snellen equivalent (logMAR + 0.5, the logarithm of the minimum angle of resolution). Based on the screening of hearing and vision, the subjects were divided into four groups: (1) with adequate sensory functions (ASF), (2) with functional hearing impairment (FHI), (3) with functional visual impairment (FVI), or (4) with combined functional sensory impairment (CSI). The descriptive values of the Barthel Index and the IADL scale were expressed using the median and interquartile range; statistical comparison between groups was made using the Mann-Whitney test or the Kruskal-Wallis test. Median regression models determined the age-adjusted effect of the functional sensory impairment to the Barthel Index and the IADL scale. Ninety-nine (20%) subjects of the sensory study population had FHI, 62 (13%) FVI, and 36 (7%) CSI. There was a statistically significant difference in the mean age between the different impairment groups (P < .001) and between the functional impairment (FHI, FVI, and CSI) and ASF groups (P < .001). The mean age ± standard deviation was 86.7 ± 5.0 in the CSI group, 81.5 ± 4.8 in the FVI group, 81.7 ± 4.1 in the FHI group, and 79.3 ± 3.4 in the ASF group. Table 1 shows the statistically significant difference between the ASF and functional impairment groups and between the functional impairment groups in the unadjusted Barthel Index and IADL scale but only between different functional impairment groups in the age-adjusted Barthel Index. We determined that 7% of our study population had CSI. It was found especially in persons aged 85 and older. CSI had an independent effect on the Barthel index even after adjustment for age. It is important to be aware of sensory problems and pay more attention to early diagnosis of specific diseases causing these problems. We must also pay more attention to educating local healthcare personnel to detect persons with sensory impairment and to refer them for consideration of technical aids and other rehabilitation maneuvers.10 The high number of older people with sensory impairments should also be taken into consideration in environmental planning. It remains to be determined whether early observation and treatment of sensory impairments could prevent long-term functional decline." @default.
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• W2019812916 date "2002-10-01" @default.
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• W2019812916 title "Combined functional visual and hearing impairment in a population aged 75 and older in Finland and its influence on activities of daily living" @default.
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• W2019812916 doi "https://doi.org/10.1046/j.1532-5415.2002.50476.x" @default.
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