With population ageing, cognitive, hearing and vision impairment are increasing in prevalence. These conditions frequently co-occur and are linked to negative outcomes including depression, poor cognitive function, social isolation, and reduced quality of life (QoL). SENSE-Cog’s aims are to: (1) understand the inter-relationship of sensory and cognitive impairments; (2) identify novel means of screening/detection for diagnostic and therapeutic purposes; and (3) translate this knowledge into clinical applications for the mental well-being of EU citizens.
THIRD PROGRESS REPORT
Poor mental health, hearing and vision impairment are all within the top 10 highest burden of disease within the EU, and are very important from the perspective of public health. Mental ill-health costs the EU over €277 billion/year (2005). Poor mental health, hearing and vision impairment frequently co-occur and are all strongly associated with age and due to ageing population demographics, the numbers of people with these conditions are set to increase.
WORK PACKAGE 1
This WP is now complete. Using existing data from several large-scale aging cohorts from the EU and the USA, we completed in-depth epidemiological analyses to explore associations of vision/hearing loss with anxiety, depression, suicidal ideation, cognitive decline and risk of dementia, including a meta-analysis across datasets.
Findings have been reported in several papers from multiple large-scale EU (& one US) include: (1) dual (hearing and vision combined) sensory loss poses a risk for depression and anxiety; (2) suicidal risk is greater in older people with hearing and/or vision loss; (3) hearing aids and cataract surgery may mitigate downward trajectories of cognitive aging; and (4) retinal changes may be an early biomarker of dementia. We have deepened understanding of the trajectory of cognitive decline in relation to sensory impairment, particularly in the very old population (over 90s).
WORK PACKAGE 2
To address the current lack of reliable assessment tools for people with cognitive and sensory impairments, we undertook a critical review of cognitive assessment tools for people with sensory impairment; a stakeholder needs’ analysis involving people with dementia (PwD), caregivers and health care professionals; development of a protocol to adapt a common cognitive tool (MOCA) and functional tool (DemPal) for people with hearing and vision impairment; and development and validation of an online tool (the E-checker) to detect cognition, hearing and vision problems.
We are nearly completion for data collection for validation of widely used cognitive test (the MOCA) adapted for people with sensory impairment We completed a critical review of online cognitive assessment tools and are mid-way through validation of our on-line screening tool (the SENSE-Cog E-checker) in five EU countries. This work will feed into an on line Toolkit for professional and lay stakeholders.
WORK PACKAGE 3
To develop a ‘sensory support intervention’ for evaluation in PwD with hearing and/or vision problems to improve their quality of life we have undertaken an iterative ‘intervention development’ programme and have started a 5-nation trial to evaluate the intervention.
We developed and field tested a new home-based psychosocial intervention to improve quality of life in people with dementia and sensory impairment, which is now being evaluated in a full randomised controlled trial in five countries and is nearly completion.
WORK PACKAGE 4
We are studying the economic cost of the interaction among mental health and sensory impairment in existing EU databases. We have completed the preparatory work for ascertaining cost-effectiveness of the sensory support intervention for WP3 via a systematic literature review, and a focus group with dementia experts. We also developed health economics’ data collection tools for the trial and field tested them.
Econometric analyses from the SHARE meta-dataset identified that cognitive and sensory impairments are associated with higher use of health care services, even after controlling for other major health conditions.
WORK PACKAGE 5
Involving PwD and their care partners is a crucial aspect of conducting meaningful research. To support, inform and guide the SENSE-Cog project and ensure that we are meeting the needs of PwD and their care partners, we have: established a network of ‘Research User Groups’ (RUGs) across the EU; trained the groups in research ;set-up a public website and social media accounts; started evaluation of the effectiveness of our training programme; and hosted successful PPI consultation and dissemination events in several EU sites, including Manchester, Athens, Nice, and Nicosia.
We held public engagement events with >250 people, spreading the principles of ‘patient and public involvement’ (PPI) in the EU. We are evaluating methods to provide a gold standard for PPI in dementia. We have a publishable protocol training evaluation for our EU-wide Research User Groups (RUGS), contributing to the methodology of conduction PPI internationally in the dementia field.
WORK PACKAGE 6 & 7
The WP6 team has successfully delivered the Steering Committee Meetings and the Annual General Meetings, held in October 2019 face-to-face in Dublin, Ireland and virtual in October 2020, and attended by all consortium partners.
We have undertaken Ethics’ Advisory Board reviews and gained approval for all work from our external ethics lead and submitted a detailed report to the European Commission for an ethics audit. Our report was favourably reviewed and no amendments were requested. Due to the COVID-19 pandemic, ongoing ethics’ amendments to WP2 and WP3 have been needed. These have been favourably reviewed by our EAB.