In this Work Package, we sought to improve aspects of assessment in people with combined sensory and cognitive problems. Under- and un-treated sensory impairments, which are common in older people with dementia (PwD), are associated with poorer mental health, more rapid cognitive decline, reduced social interactions and poor quality of life. A key factor in the high rates of under- and un-treated sensory impairment is the lack of valid and reliable assessment tools for these domains. People with cognitive impairment or PwD, often do not report hearing and vision impairments. Likewise, people with hearing and vision problems have difficulty completing cognitive assessment tests, since most of these tests rely on intact hearing and vision. Thus, the care of people with these combined problems is often sub-optimal. To address this, we undertook the following tasks:
• A gold-standard critical review of the presence and utility of existing cognitive assessment tools that have been adapted for people with sensory impairment;
• A stakeholder needs’ analysis involving people with dementia (PwD), caregivers and health care professionals from France, Cyprus and the UK, describing the needs of PwD, their care partners and healthcare professionals in relation to assessment of hearing, vision and cognitive impairment in older adults;
• A synthesis of the findings from the review and the stakeholders’ needs analysis to select and adapt specific cognitive and sensory assessment tools that we will validate and make available to the general public and health care professionals in the next part of the research.
Results and potential impact
In our critical review of the existing literature, we found that some attempts have been made to adapt cognitive tests for people with acquired hearing and/or vision impairment, but the validity of the adapted scales has not been established. Thus, we have clearly identified the need to improve cognitive assessments for people with hearing and vision impairment. We have also laid the ground work for developing an on-line screening tool for people to self-manage their sensory and cognitive health by determining whether they have a clinically significant problem in hearing, vision or cognition. This will foster early identification and treatment. The tool will be inexpensive and widely available via smartphone and computer platforms, usable by non-experts, and applicable with hard-to-reach populations across gender, geographical location, socio-economic status and ethnicity.