Prevalence, Associated Factors and Health-related Quality of Life of Dual Sensory Impairment in Residential Care Facilities in Singapore

ABSTRACT

Purpose

To investigate the prevalence of dual sensory impairment (DSI), its associated factors and relationship with health-related quality of life (HR-QoL) in residential care facilities (RCF) in Singapore.

Methods

This was a cross-sectional study of 123 residents aged ≥40 years from six RCFs, conducted between 2016 and 2018. DSI was defined as concomitant presenting visual acuity (better-eye) >0.3 logarithm of the minimum angle of resolution and a pure-tone air conduction threshold (better-ear) >40 dB HL in any of the four tested frequencies (500, 1000, 2000 and 4000 Hz). HR-QoL was quantified using the EuroQol five-dimension questionnaire. Multivariable Poisson regression was used to determine the associated factors of DSI. Multivariable linear regression was used to determine the association between DSI and HR-QoL adjusted for traditional confounders.

Results

Of the 123 residents (age [mean±standard deviation] 75.3 ± 10.8 years; 56.9% male), 97 (78.9%[95% confidence interval(CI):71.6%, 86.1%]) had DSI, with 110 (98.2%) not on follow-up care for their sensory disabilities. In multivariable models, male gender (prevalence ratio(PR) [95%CI] = 1.3[1.1, 1.6]), older age (per 10-year increase (1.2[1.1, 1.3])), education ≤6 years (1.3[1.1, 1.7]) and the presence of cataract (1.3[1.0, 1.7]) were independently associated with DSI. DSI was independently associated with a substantial worsening in HR-QoL (β = −0.61; 95%CI: −0.76, −0.45; p < .001).

Conclusions

DSI affects four in five residential care residents and is substantially associated with reductions in HR-QoL in these residents. Our finding highlights an urgent need for the implementation of routine vision and hearing screening and follow-up care for residents living in these facilities.

KEYWORDS:

• Prevalence
• vision impairment
• hearing loss
• dual sensory impairment
• residential care facilities
• nursing home

Acknowledgments

We would like to acknowledge Singapore’s Agency of Integrated Care, and staff and residents of the six RCFs that participated in this research project without which this study would not have been possible: Ling Kwang Home for Senior Citizens, Green Avenue Home for the Elderly, Kwong Wai Shiu Hospital, Man Fut Tong Nursing Home, NTUC Health Nursing Home and Sree Narayanan Mission Singapore.

Disclosure statement

No conflicting relationship exists for any author

Additional information

Funding

This study was funded by the National Medical Research Council (#CNIG15may023). Professor Lamoureux is supported by the National Medical Research Council Senior Clinician Scientist Award (NMRC/CSA-SI/0009/2016). Asst. Prof. Man is supported by the NMRC Transition Award (#MOH-TA19may-0002). The funding organizations had no role in the design or conduct of this research or preparation of this manuscript; National Medical Research Council [NMRC Senior Scientist Award (NMRC/CSA-SI/0009/2016)]; National Medical Research Council [NMRC Transition Award (#MOH-TA19may-0002)];