Cognitive Decline, Sensory Impairment, and The Use of Audio-Visual Aids by Long-Term Care Facility Residents

Abstract BackgroundAudio-visual impairments and the use of sensory aids are associated with cognitive decline in community-dwelling older people, but effects in long-term care settings are unclear. We hypothesize that visual and hearing impairment are associated with cognitive decline and these relationships are mediated by the use of visual and hearing aids.MethodsA secondary data analysis of a longitudinal study was conducted in the 7 government-subsidized long-term care facilities (LTCF) operated by one of the largest non-governmental organizations in Hong Kong using data between 2005 and 2016. Eligible residents were ≥60 years of age without severe cognitive impairment at baseline who had stayed in the facilities for more than three years. All variables were measured by using the Minimum Data Set-Resident Assessment Instrument Version 2.0, Hong Kong version. The outcome was cognitive decline. Predictors were visual and hearing impairments. Mediators were use of visual and hearing aids. General linear models were employed to test the hypotheses.ResultsResults for 2,233 residents were analyzed, with the mean age of 82.1±8.2 years and the mean follow-up period of 4.4±0.8 years. Results showed that those who had visual impairment (p=0.004) and hearing impairments (p=0.022) had a higher risk of cognitive decline. Using hearing aids (coefficient=0.0186, p<0.05) positively mediates the effect of hearing impairment on cognitive decline. Using visual aids (coefficient=-0.0881, p<0.05) negatively mediates the effects of visual impairment on cognitive decline. ConclusionIn long-term care settings, hearing and visual impairments are associated with higher risk of cognitive decline. Hearing aids often-users are associated with higher risk of cognitive decline. LTCF residents with visual impairment did not use visual aids. Visual aids protects residents from cognitive decline.