Better support when it gets harder to see, hear or think
Your hearing's shot, your memory is playing up, and your eyesight isn't what it used to be... Many of us will develop two or more of these impairments as we age. Their combined effect on older persons' ability to cope is greater than the sum of its parts, say EU-funded researchers who are working on ways to attenuate this joint impact.
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The SENSE-Cog project is dedicated to the joint effect of age-related cognitive and sensory difficulties, in a bid to improve the quality of life of older persons with dementia.
At the moment, such impairments are diagnosed, tested and treated individually in isolated pockets, but of course there are tremendous interrelationships between them, says project coordinator Iracema Leroi of the University of Manchester, United Kingdom.
The SENSE-Cog project runs for four years to December 2020. It is conducting research into the connections between age-related hearing loss, vision impairments and cognitive difficulties, and developing assessment tools that will enable doctors to support patients more effectively.
Within the overall project, a clinical trial is also assessing how interventions to improve the sight or hearing of older persons with dementia might help them to have a better quality of life and even improve their cognition. The trial will also determine what such interventions would imply in terms of cost and possible longer-term savings for health care systems and society as a whole.
SENSE-Cog focuses on giving people with dementia and their care partners a voice, both within the project and in the wider world, says Leroi. We have developed methodology and networks to interact with people who are living with these problems to get their views on the work that we are doing, she notes. At the same time, we are using the opportunity to foster links between organisations dedicated to hearing, vision and dementia.
Analysing the interactions
Establishing how, exactly, one impairment amplifies another is one of the projects main objectives. To provide an example of these sinister synergies, Leroi mentions situations where assessments of a persons cognitive abilities are inconclusive because the patient cant actually hear or read the questions.
The reverse also applies, she adds: tests of hearing ability can produce unreliable results for people with cognitive difficulties who may not quite understand whats required.
As a result, it can be extremely difficult to establish the precise nature and extent of a persons problems, Leroi notes which, in turn, makes it harder to provide effective help for the difficulties that could be addressed. For elders whose ability to make sense of the world is affected by a combination of these impairments, taking at least one out of the equation could make a major difference.
Solutions as simple as providing suitable spectacles or hearing aids could go a long way. And yet, says Leroi, most senior citizens have never even taken a hearing test, and many use glasses made to outdated prescriptions.
Generating awareness and solutions
By the end of the project, in December 2020, our broad aim is to have a better understanding of interrelationships between hearing, vision and cognition, and to develop a risk model based on epidemiological data, says Leroi.
The team is looking into a variety of aspects, such as levels of anxiety and poor mental health in older persons with hearing and vision loss, for which a high association was found. Another study carried out as part of the project is dedicated to retinal changes as a potential biomarker for changes in cognitive ability linked with the onset of dementia.
The SENSE-Cog team is also planning to produce clinical assessment tools that will be valid for people with combinations of hearing, sight and thinking difficulties, she adds, along with a self-screening system that would enable users to determine if their problems are significant enough to seek medical advice.
By the time the project ends in December 2020, SENSE-Cog aims to provide older citizens and their doctors with new knowledge and practical tools.