Evaluation of Cognitive Functioning in the Context of Rehabilitation for Visual Impairment in Older Adults: A Case Series

ABSTRACT

Aims: As the risk of visual impairment increases with age, so does the risk of developing cognitive impairment. Detection of cognitive deficits in people with visual impairments is a challenge and it remains unclear to what extent cognitive issues impact daily habits and the rehabilitation process. The present study aimed to (1) verify the consistency between the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) (“Blind” versions) and the therapist's observations of elderly individuals in low-vision rehabilitation (LVR), and (2) document how cognitive difficulties may influence LVR and the satisfactory carrying-out of life habits. Methods: Six elderly individuals who received LVR completed the MMSE and MoCA (“Blind” versions) and Assessment of Life Habits (LIFE-H). The therapist rated the achievement of rehabilitation objectives, clients' cognitive functioning and its impact on the rehabilitation process. Results: All participants obtained scores within the normative score range for both tests except for one participant on the MoCA. The therapist perceived that four out of six participants had cognitive difficulties significant enough to hinder the rehabilitation process and these persons required more adaptations to therapy. All participants were satisfied with their life habits despite remaining functional limitations and the need for assistance. Conclusions: In this sample, standardized cognitive tests had limited utility to predict the complexity of LVR. Even if present, cognitive difficulties do not preclude rehabilitation for even severe visual impairment in elderly persons and does not imply significantly longer or more intense rehabilitation.

KEYWORDS:

• Older adults
• low vision rehabilitation
• cognition
• life habits

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Acknowledgments

The authors would like to thank Danielle Giguère, Mireille Prémont, Manon Lachance, Johanne Picard, Caroline Charest and Louise Martel who contributed to this study. We thank Simon Beaulieu-Bonneau and Danielle Tessier for reviewing the text. Finally we thank the six participants, and the Institut de Réadaptation en Déficience Physique de Québec for its financial support.

Funding

This study was supported by a grant from the clinical research support program of the Institut de réadaptation en déficience physique de Québec.