Prevalence and Correlates of Hearing and Visual Impairments in European Nursing Homes: Results From the SHELTER Study

Background

Visual and hearing impairments are known to be related to functional disability, cognitive impairment, and depression in community-dwelling older people. The aim of this study was to examine the prevalence of sensory impairment in nursing home residents, and whether sensory impairment is related to other common clinical problems in nursing homes, mediated by functional disability, cognitive impairment, and depressive symptoms.

Methods

Cross-sectional data of 4007 nursing home residents in 59 facilities in 8 countries from the SHELTER study were analyzed. Visual and hearing impairments were assessed by trained staff using the interRAI instrument for Long-Term Care Facilities. Generalized linear mixed models adjusted for functional disability, cognitive impairment, and depressive symptoms were used to analyze associations of sensory impairments with prevalence of clinical problems, including behavioral symptoms, incontinence, fatigue, falls, problems with balance, sleep, nutrition, and communication.

Results

Of the participants, 32% had vision or hearing impairment (single impairment) and another 32% had both vision and hearing impairments (dual impairment). Residents with single impairment had significantly higher rates of communication problems, fatigue, balance problems, and sleep problems, as compared with residents without any sensory impairment. Those with dual impairment had significantly higher rates of all clinical problems assessed in this study as compared with those without sensory impairment. For each clinical problem, the magnitude of the odds ratio for specific clinical problems was higher for dual impairment than for single impairment.

Conclusion

Visual and hearing impairments are associated with higher rates of common clinical problems among nursing home residents, independent of functional disability, cognitive impairment, and depressive symptoms.     

某发电厂职业性噪声听力损伤状况分析

目的了解并分析珠海市某发电厂职业性噪声听力损伤状况。方法对珠海市某电厂300名噪声作业工人的纯音听力测定,对听力损伤情况进行分析。结果本组共检测300人。按高频（3000、4000、6000Hz）任一频率听力下降≥30dB,计算双耳平均听阈,评定听力损伤,其中轻、中、重度听力损失者共220人,患病率73％,听力正常80人,占27％。与处于噪音工作环境相关,听力损伤随工龄而升高,听力损伤差异有统计学意义（P〈0．01）。结论听力损伤与噪声作业环境有关,应当引起重视,须对作业工人加强听力保护。     

Prevalence of Hearing Impairment and Hearing Complaints in Older Adults: A Study in General Practice

In one general practice, 660 people aged 60 years or over werescreened by means of pure tone audiometry and a specific questionnaireto assess the prevalence of hearing impairment and hearing complaints.Hearing impairment was defined as an average loss of 35 dB ormore in the 1, 2 and 4 kHz frequencies in one or both ears.In total, 37.4% (95% Cl, 33.3–41.1%) of the participantswas hearing impaired. The prevalence was higher in men (55.1%)than in women (44.9%) and clearly increased with age in bothsexes. The prevalence of hearing complaints in terms of hearingdifficulties and/or tinnitus, was 37.3% (95% Cl, 33.6–41.0%),and increased with age, especially in women. Of the subjectswith hearing impairment, 64.4% reported hearing complaints.Of the subjects without hearing impairment, 21.1% experiencedhearing complaints. This study suggests that screening olderadults with relatively simple methods, may identify a largeproportion of men and women in general practice with hearingproblems. Providing information to both patients and generalpractitioners about the possibilities of hearing improvementis a crucial step in making people become more aware of hearingproblems. This could ultimately lead to improvement of the qualityof life of older men and women with hearing problems.     

非综合征型神经性耳聋的线粒体基因突变研究(英文)

目的探讨国人非综合征型神经性耳聋患者线粒体基因突变。方法收集非综合征型神经性耳聋病例262例,其中散发病例168例,69例同代有耳聋患者,25例不止1代有耳聋患者,采用限制性片段长度多态性分析线粒体基因中的下列3个点突变:1555A→G,3243A→G,7445A→G。结果在5个母系遗传家系和10个散发病例中发现线粒体基因突变,占全部病例的5.7%。结论应考虑在非综合征型神经性耳聋中患者线粒体基因突变的筛查,特别是母系遗传家系成员。     

上海市7岁以下儿童听力障碍流行病学研究

目的 调查上海市７岁以下儿童听力障碍现患情况及原因探索。方法 用测听仪器检测受调查儿童。结果 听儿障碍的现患率为３．４３％。市区以中、轻度为多,效县以重度以上为主（Ｐ〈０．０５）。〈３岁以重度以上为多,≥３岁以轻度为主（Ｐ〈０．０５）。致小儿听力障碍的危险因素主要是曾用过耳毒性药物和婴幼儿期曾患疾病史（包括头颅外伤、反复上呼吸道感染和渗出性中耳炎）。结论 要进一步健全全市听力筛查网络,提高检测水平、尤其是效县。儿童应禁用中毒性药物;对有既往疾病史的高危儿童,要重点进行听力检测,做到早发现、早干预,早期康复。     

中国听力残疾人群现状及致残原因分析

目的 掌握中国听力残疾人群现状及致残原因.方法 采用统计描述和统计推理等方法对第二次全国残疾人抽样调查数据进行分析.结果 中国现有听力残疾人口2780万,单纯听力残疾2004万人,听力残疾现患率为2.11%,单纯听力残疾现患率为1.52%(占72.08%);60岁及以上老年人现患率为11.04%(占73.57%),农村现患率高于城市,男性现患率高于女性.总体三、四级听力残疾占73.42%,60岁及以上组听力残疾三、四级占79.13%;4～6岁组一、二级残疾占67.36%,0～3岁组一、二级残疾占83.90%.在0～6岁听力残疾中70%以上并有言语残疾.残疾人职业集中在农、林、牧、渔、水利业,受教育程度比较低.全部人群主要致残原因是老年性聋、原因不明性耳聋和中耳炎,0～6岁听力残疾的主要致残原因,除不明原因外依次为遗传、母孕期病毒感染、新生儿窒息、药物性耳聋、早产和低出生体重儿;60岁及以上组主要致残原因依次为老年性耳聋、中耳炎、全身性疾病、噪声和爆震及药物性耳聋等.结论 积极预防老年性聋的发生,尤其加强农村人口和男性人群的防治工作,是降低听力残疾发生风险的重要因素.积极开展遗传咨询,预防新生儿出生听力缺陷,对减少儿童听力残疾具有重要意义.     

Hearing aid use in nursing homes. Part 2: Barriers to effective utilization of hearing AIDS

OBJECTIVE: This study examined barriers to hearing aid use among persons who were reported to have a hearing aid and among those reported to have hearing difficulties but no hearing aids. SETTING: Interviews were conducted at a large, mid-Atlantic nonprofit nursing home. PARTICIPANTS: Both nursing home residents (279) and nursing staff members (51) were interviewed. DESIGN AND MEASUREMENTS: In a cross-sectional survey of nursing home residents, brief structured interviews were performed by trained research assistants with both residents and caregivers to obtain information regarding residents' hearing ability, hearing aid use and daily maintenance, and potential barriers to such use. RESULTS: Among residents reported to have hearing problems but who did not use a hearing aid, the major problem was neglect of the issue; participants did not know why residents did not have a hearing aid, residents had not had hearing evaluations, and staff members were not aware of hearing problems in residents. Among residents who did use a hearing aid, the majority (69%) of those for whom information was available had problems with the devices. The most common problems reported were that the device was hard or inconvenient to use, it did not fit well or hurt, and the device was not functioning well. The vast majority (86%) needed help taking care of the hearing aids. Close to half of the staff members had not received any training in the use or maintenance of the devices. Lack of delegation of responsibility for the management of hearing was identified for 29%, and relatives were used for maintenance of hearing aids in 14% of residents with hearing aids. CONCLUSIONS: Barriers to hearing aid use are therefore complex and multifactorial, involving lack of system commitment to utilization of hearing aids, lack of knowledge by staff members, inappropriate delegation and care procedures, hearing aid design and fit issues, and difficulties for residents in handling the hearing aids. Addressing these issues requires change on multiple levels, including change at the institutional level, concerning policy and training; change at the unit level, regarding care procedures and follow up; change at the individual level, providing better checks of fit and function of the hearing aids; and finally, change at the societal level, addressing design and cost issues for hearing aids in this population.     

Physical Exercise Helped to Maintain and Restore Functioning in Chinese Older Adults With Mild Cognitive Impairment: A 5-Year Prospective Study of the Hong Kong Memory and Ageing Prospective Study (HK-MAPS)

Objective

This study investigated the potential of physical exercise habit as a lifestyle modification against cognitive and functional decline at the community level.

Association Between Late-Life Blood Pressure and the Incidence of Cognitive Impairment: A Community-Based Prospective Cohort Study

Objectives

To investigate the association between late-life blood pressure and the incidence of cognitive impairment in older adults.

Association Between Accumulation of Advanced Glycation End-Products and Hearing Impairment in Community-Dwelling Older People: A Cross-Sectional Sukagawa Study

Objectives

The experimental studies suggested the hypothesis that the accumulation of advanced glycation end-products (AGEs) could induce hearing impairment. The purpose of this study is to examine the hypothesis among elderly people using an epidemiologic approach.

Identification of a Novel Compound Heterozygous Mutation in OTOG in a Chinese Family with Severe Hearing Impairment

Objectives::Hearing loss is a worldwide disease. In 50% of the patients, hearing loss is caused by genetic problems associated with GJB2, MTRNR1, ...     

Visual Concerns that Interfere with Daily Activities in Patients on Rehabilitation Units: A Descriptive Study

The purpose of this study was to estimate the prevalence of patients with visual concerns that interfere with their activities of daily living (ADL) performance in physical rehabilitation units through occupational therapy assessment. Over the two-month study period, 215 adult inpatients from a physical rehabilitation hospital were evaluated using the Brief Vision Screen (BVS) through ADL. The BVS assessed four areas of visual concerns, namely left visual field, focusing, and near- and low-contrast acuity, while patients engaged in ADL. The occupational therapists identified 33% of patients who had at least one area of visual concern, with the largest proportion diagnosed with stroke (55%), followed by pulmonary disease (40%) and joint replacement (35%). When comparing the four areas of visual concerns in the BVS between the two major diagnostic groups (acquired brain injury, ABI and non-acquired brain injury, non-ABI), a significantly higher proportion of patients with ABI were identified as having left hemianopsia concerns compared to patients with non-ABI. No significant difference was observed in other areas of visual concern between the two groups. Findings indicated that visual concerns that interfere with ADL performance among older patients in rehabilitation units are common. The high proportion of patients with pulmonary disease identified as having visual concerns warranted further confirmation and investigation. Preliminary evidence to support the psychometric properties of the BVS for identifying visual concerns in patients on rehabilitation units was established.     

Pharmacologic Treatment for Hypoactive Delirium in Adult Patients: A Brief Report of the Literature

ObjectivesThe purpose of this report was to identify medications that can be used to treat hypoactive delirium.DesignA systematic search of PubMed and Web of Science from inception through September 20, 2020.Setting and ParticipantsReports evaluating different pharmacologic treatments for hypoactive delirium in adults (age 18 years and older) and geriatric patients were included.MethodsThree independent investigators reviewed the abstracts, using the Rayyan QCRI review tool to decide which articles were eligible for inclusion. Hereafter, articles were read completely for final inclusion. Study quality was assessed using the guidelines from the National Institute for Health and Care Excellence for cohort studies and randomized control trials.ResultsOf the 52 relevant articles, only 4 (8%) met the selection criteria. Two were cohort studies whereas the other 2 were randomized control trials. After further review, one of the reports was excluded because the same data were used as in one of the randomized control trials. In total, 4 different pharmacologic therapies were used in the selected studies: haloperidol, ziprasidone, aripiprazole, and methylphenidate. Aripiprazole showed a complete resolution of hypoactive delirium (P < .001), and methylphenidate showed a significant amelioration in cognitive function (P < .001). Ziprasidone and haloperidol did not show significant differences compared with placebo.Conclusions and ImplicationsA limited number of clinical studies on the treatment of hypoactive delirium are available. Aripiprazole and methylphenidate showed promising results in the treatment of hypoactive delirium.     

老年认知功能障碍患者实施走失风险管理的效果探讨

目的 观察老年认知功能障碍患者实施走失风险管理的效果.方法 本院2018年4月—2019年4月收治的64例老年认知功能障碍患者为本次研究对象,按照随机分组法将所有患者分为为对照组(32例:常规管理)与试验组(32例:综合走失风险管理),比较两组患者管理情况.结果 试验组管理期间走失率(3.13％)以及不良反应发生率(9...     

The Impact of Cognitive Impairment on Efficacy of Pulmonary Rehabilitation in Patients With COPD

Objectives

To compare changes in pulmonary rehabilitation (PR) dropout and outcomes between chronic obstructive pulmonary disease (COPD) patients with and without cognitive impairment.

Association of Blindness and Hearing Impairment with Mortality in a Cohort of Elderly Persons in a Rural Area

Background:

Studies in developed nations have reported an association of blindness and hearing impairment with mortality in elderly persons.

Objectives:

To study the association of blindness and hearing impairment with mortality in a cohort of elderly persons in rural north India.

Materials and Methods:

This community-based prospective study was conducted in eleven randomly selected villages, in Ballabgarh block, Haryana. A cohort of 1422 participants, of age 60 years and above, was examined at baseline, for their visual and hearing status. Data on the sociodemographic factors, various comorbidities, activities of daily living, and self-rated health were recorded. Baseline data was collected for the period May 2008 to August 2008. Follow-up data collection for mortality was completed in December 2009. The median follow-up period was 518 days.

Results:

One hundred out of 1422 elderly (7.0%) participants died during the follow-up period. Significant hazard ratios were found after adjustment for various comorbid conditions. On adjustment for sociodemographic factors (age, sex, and literacy), neither blindness nor hearing impairment was found to be significantly associated with mortality. After adjustment for all covariates in the study, hearing impairment (Hazard Ratio = 2.13; 95% CI, 1.29 – 3.54) was found to be significantly associated with mortality in the age group ≥70 years.

Conclusions:

This study demonstrated that hearing impairment was an independent risk factor for mortality in people aged ≥70 years. Similar studies with a longer period of follow-up are required in India, to guide public health interventions.     

Factors Associated with Step Numbers in Acutely Hospitalized Older Adults: The Hospital-Activities of Daily Living Study

ObjectivesTo determine the number of steps taken by older patients in hospital and 1 week after discharge; to identify factors associated with step numbers after discharge; and to examine the association between functional decline and step numbers after discharge.DesignProspective observational cohort study conducted in 2015–2017.Setting and ParticipantsOlder adults (≥70 years of age) acutely hospitalized for at least 48 hours at internal, cardiology, or geriatric wards in 6 Dutch hospitals.MethodsSteps were counted using the Fitbit Flex accelerometer during hospitalization and 1 week after discharge. Demographic, somatic, physical, and psychosocial factors were assessed during hospitalization. Functional decline was determined 1 month after discharge using the Katz activities of daily living index.ResultsThe analytic sample included 188 participants [mean age (standard deviation) 79.1 (6.7)]. One month postdischarge, 33 out of 174 participants (19%) experienced functional decline. The median number of steps was 656 [interquartile range (IQR), 250–1146] at the last day of hospitalization. This increased to 1750 (IQR 675–4114) steps 1 day postdischarge, and to 1997 (IQR 938–4098) steps 7 days postdischarge. Age [β = ?57.93; 95% confidence interval (CI) ?111.15 to ?4.71], physical performance (β = 224.95; 95% CI 117.79–332.11), and steps in hospital (β = 0.76; 95% CI 0.46–1.06) were associated with steps postdischarge. There was a significant association between step numbers after discharge and functional decline 1 month after discharge (β = ?1400; 95% CI –2380 to ?420; P = .005).Conclusions and ImplicationsAmong acutely hospitalized older adults, step numbers double 1 day postdischarge, indicating that their capacity is underutilized during hospitalization. Physical performance and physical activity during hospitalization are key to increasing the number of steps postdischarge. The number of steps 1 week after discharge is a promising indicator of functional decline 1 month after discharge.     

Prevalence of Malnutrition in Older Hospitalized Cancer Patients: A Multicenter and Multiregional Study

The journal of nutrition, health & aging - Malnutrition is frequent in older cancer patients, with a prevalence that ranges from 25% to 85%. The aging process is associated with several...