Impact of an intervention to support hearing and vision in dementia: The SENSE‐Cog Field Trial

Abstract

Objectives Hearing, vision, and cognitive impairment commonly co‐occur in older adults. Improving sensory function may positively impact outcomes in people with dementia (PwD). We developed a “sensory intervention” (SI) to support hearing and vision in PwD. Here, we report the findings of an international open‐label field trial, and nested case series, to explore the impact of the SI on dementia‐related outcomes. Methods This was a home‐based trial conducted in France, England, and Cyprus. Participants were people with mild‐to‐moderate dementia and hearing and/or vision impairment (n = 19) and their study partners (unpaid carers; n = 19). The “basic” SI included a hearing and vision assessment and provision of glasses and/or hearing aids. A subsample received the “extended” SI with additional weekly visits from a sensory support therapist (SST). Exploratory analyses of dementia‐related, health utility and resource utilisation outcomes were performed. Results Quality of life (QoL) and sensory functional ability improved. Change in QoL exceeded the threshold for a minimum clinically important difference. There was a modest improvement (in absolute terms) post intervention in behavioural disturbance, self‐efficacy, and relationship satisfaction. Study partner time assisting instrumental activities of daily living (iADL) and supervision decreased by about 22 and 38 hours per month, respectively, although time for personal ADL support increased. Qualitative data supported effectiveness of the intervention: PwD were more socially engaged, less isolated, less dependent on study partners, and had improved functional ability and communication. Conclusions These findings support the need for a definitive randomised controlled trial (RCT) to evaluate the effectiveness of the intervention.

A randomised controlled trial of hearing and vision support in dementia: Protocol for a process evaluation in the SENSE-Cog Trial

“…Adherence support for PwD with sensory devices will enhance hearing [29], vision [30], or both [15].…”

A randomised controlled trial of hearing and vision support in dementia: Protocol for a process evaluation in the SENSE-Cog Trial

“…Adherence support for PwD with sensory devices will enhance hearing [29], vision [30], or both [15]. Furthermore, social opportunities will be enhanced through signposting outside the home, thus addressing social isolation, improving social relationships, and providing respite for companions.…”

“…Another strength of our approach includes the sound theoretical framework on which the intervention was developed, and the iterative manner in which it was modified and field-tested [12,15] before arriving at the final version of the intervention, ready for full scale effectiveness testing. A limitation (although also a potential strength) is the significant degree of variability in the study sites due to the different EU contexts in which the programme takes place, as well as the variability of the intervention offered to each participant dyad, resulting from the tailored approach.…”

“…The findings were synthesized into a draft SI that was then field tested in the UK, France and Cyprus [13][14][15], prior to development of the protocol for the full multi-site RCT [16], the SENSE-Cog Trial.…”

Hearing loss and cognitive function among Chinese older adults: The role of participation in leisure activities

“…Age-related hearing loss may be associated with an increased risk of dementia in later life, which has garnered increasing attention as a potentially modi able risk factors for dementia and cognitive decline [10][11][12]. Evidence from a randomized controlled trial regarding hearing support in dementia (i.e., SENSE-Cog Field Trial) demonstrated that employing a sensory intervention to support hearing, such as providing hearing aids, communication training, and supplementary sensory aids to enhance the home environment or foster social inclusion, bene ts people with dementia as well as their partner by improving their quality of life, physical functions, psychosocial health and relationship satisfaction [15,16]. Moreover, studies have indicated that hearing aid use confers a mitigating effect on the trajectories of cognitive decline by maintaining cognitive function, such as episodic memory [17,18].…”