Tien Tay

Sensory and Cognitive Association in Older Persons: Findings from an Older Australian Population

Background: Explanations for associations found between sensory and cognitive function remain unclear. Objective: To assess in an older Australian population: (1) the correlation between sensory and cognitive function across groups with a narrow age range; (2) any independent association between sensory and cognitive impairment. Methods: We examined 3,509 non-institutionalised residents aged 50+ years in the second cross-sectional survey of the Blue Mountains Eye Study (1997–2000). Visual impairment was defined for best-corrected visual acuity (VA) <6/12 in the better eye, moderate to severe hearing loss for hearing threshold >40 dB (better ear), and likely cognitive impairment for Mini-Mental State Examination (MMSE) <24 points. Results: We found likely cognitive impairment in 3.3%, vision impairment in 2.7% and moderate to severe hearing loss in 10.5% of this population. Correlation between VA or hearing threshold and MMSE score increased with age. After adjusting for age, weak but significant correlation was evident in the normal ageing sample between vision and MMSE (r = 0.12 with vision items included and r = 0.11 with vision items excluded, both p < 0.0001), and between hearing thresholds and MMSE (r = –0.12, p < 0.0001). After adjusting for age, sex, education and history of stroke, persons with vision impairment had a lower mean MMSE score than those with normal vision, regardless of whether vision-related items were included (27.1 vs. 28.6, p < 0.001) or excluded (19.8 vs. 21.0, p < 0.001). Similarly, persons with moderate to severe hearing loss had a lower mean MMSE score than those without hearing loss (28.1 vs. 28.7, p < 0.001). Persons with likely cognitive impairment also had lower mean VA and higher mean hearing threshold than those without, after adjustment. Conclusions: We have documented an age-related correlation between sensory and cognitive function in a normal ageing sample. The association between sensory impairment and likely cognitive impairment remained significant after excluding vision-related MMSE items and adjusting for confounding factors. Our data suggest that age-related decline and the effect of visual impairment on the measurement of cognition only partly explain the association between sensory and cognitive impairments in older persons.

Prevalence and causes of visual impairment in craniosynostotic syndromes.

Background:  To assess the prevalence and causes of visual impairment in patients with craniosynostotic syndromes of Apert, Crouzon, Pfeiffer, Saethre–Chotzen and craniofrontonasal dysplasia.

Sensory Impairment, Use of Community Support Services, and Quality of Life in Aged Care Clients

Objective: To assess influences from visual or hearing impairment on use of community support services and health-related quality of life in aged care clients. Method: The authors sampled 284 frail elderly individuals presenting for assessment in Sydney, Australia. Moderate to severe visual impairment was defined as visual acuity <20/80 (better eye), and moderate to severe hearing loss as hearing thresholds >40 decibels (better ear). Community support services included home-delivered meals, home help, and community nurse visits. Results: After adjusting for age, sex, and two or more comorbid conditions, moderate to severe visual impairment, but not moderate to severe hearing loss, was significantly associated with increased use of community services (adjusted odds ratio 2.8, 95% confidence interval = 1.0—7.8). Conclusion: Moderate to severe visual impairment was associated with an increased likelihood of community service utilization in this aged care client sample.

Eye care service utilization in older people seeking aged care

Background:  To assess the need for, and the use of eye care services in older people seeking aged care.

Nanophthalmos in a Melanesian population

Purpose:  To characterize the ophthalmic features and causes of visual loss in a cohort of Melanesians living in New Caledonia with nanophthalmos.

Vision and Self-Rated Health: Longitudinal Findings from an Older Australian Population

Purpose: To assess temporal associations between vision and self-rated health. Methods: We examined 3654 Australian residents (82.4% response) aged 49+ years in the Blue Mountains Eye Study, during 1992 to 1994, and re-examined 2334 in 1997 to 1999. Change in vision was defined if baseline and 5-year visual acuity (VA) changed by ≥10 letters (2 lines). Change in self-rated health was defined if overall health ranking (excellent, good, fair, poor) changed by ≥1 step. Results: Of 2285 participants with data from both examinations, 59.8%, 23.9%, and 16.3% reported unchanged, declined, and improved self-rated health, respectively. Among persons whose self-rated health declined, the proportions with a decline in presenting VA, no change, or improvement were similar (25.2%, 23.8% and 22.5%, respectively, p for trend = 0.5). Among participants with decline, no change, or improvement in self-rated health, a similar magnitude in the age-sex adjusted mean VA decline (−1.0 to −2.7 letters) was observed. After adjusting for age, sex, hospitalizations, and incident chronic conditions, declining VA was not associated with increased decline in 5-year self-rated health (multivariate-adjusted odds ratio 0.99, 95% CI 0.75–1.30). Conclusion: There were no parallel 5-year changes in self-rated health and vision in this population.