Department of Geriatrics, First Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Nursing, Faculty of Health Sciences, Palacky University, Olomouc, Czech Republic.
Department of Geriatrics, First Faculty of Medicine, Charles University, Prague, Czech Republic.
J Am Med Dir Assoc. 2014 Oct;15(10):738-43. doi: 10.1016/j.jamda.2014.05.012. Epub 2014 Jun 28.
Visual and hearing impairments are known to be related to functional disability, cognitive impairment, and depression in community-dwelling older people. The aim of this study was to examine the prevalence of sensory impairment in nursing home residents, and whether sensory impairment is related to other common clinical problems in nursing homes, mediated by functional disability, cognitive impairment, and depressive symptoms.
Cross-sectional data of 4007 nursing home residents in 59 facilities in 8 countries from the SHELTER study were analyzed. Visual and hearing impairments were assessed by trained staff using the interRAI instrument for Long-Term Care Facilities. Generalized linear mixed models adjusted for functional disability, cognitive impairment, and depressive symptoms were used to analyze associations of sensory impairments with prevalence of clinical problems, including behavioral symptoms, incontinence, fatigue, falls, problems with balance, sleep, nutrition, and communication.
Of the participants, 32% had vision or hearing impairment (single impairment) and another 32% had both vision and hearing impairments (dual impairment). Residents with single impairment had significantly higher rates of communication problems, fatigue, balance problems, and sleep problems, as compared with residents without any sensory impairment. Those with dual impairment had significantly higher rates of all clinical problems assessed in this study as compared with those without sensory impairment. For each clinical problem, the magnitude of the odds ratio for specific clinical problems was higher for dual impairment than for single impairment.
Visual and hearing impairments are associated with higher rates of common clinical problems among nursing home residents, independent of functional disability, cognitive impairment, and depressive symptoms.
在社区居住的老年人中，视力和听力障碍与功能障碍、认知障碍和抑郁有关。本研究旨在调查养老院居民中感官障碍的流行率，以及感官障碍是否通过功能障碍、认知障碍和抑郁症状与养老院中其他常见临床问题相关，是否存在中介作用。
对 SHELTER 研究中 8 个国家的 59 个设施的 4007 名养老院居民的横断面数据进行分析。视力和听力障碍由经过培训的工作人员使用用于长期护理设施的 interRAI 工具进行评估。使用广义线性混合模型调整功能障碍、认知障碍和抑郁症状，分析感官障碍与临床问题（包括行为症状、尿失禁、疲劳、跌倒、平衡问题、睡眠、营养和沟通问题）的患病率之间的关联。
参与者中有 32%存在视力或听力障碍（单感官障碍），另有 32%同时存在视力和听力障碍（双感官障碍）。与没有任何感官障碍的居民相比，单感官障碍患者的沟通问题、疲劳、平衡问题和睡眠问题发生率明显更高。与没有感官障碍的患者相比，双感官障碍患者所有评估的临床问题发生率均明显更高。对于每种临床问题，双感官障碍的特定临床问题的比值比都高于单感官障碍。
视力和听力障碍与养老院居民常见临床问题的发生率较高有关，且独立于功能障碍、认知障碍和抑郁症状。
