Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
Department of Psychology, University of Toronto, Toronto, ON, Canada.
J Alzheimers Dis. 2019;68(3):1039-1049. doi: 10.3233/JAD-181129.
Vision impairments are prevalent, but underdiagnosed in individuals with dementia living in long-term care (LTC). Effective screening tools could identify remediable vision problems. This scoping review was conducted to identify vision screening tests used with individuals with dementia and assesses their suitability for administration by nurses in LTC. A literature search using the Arksey and O'Malley (2005) method included research articles, conference proceedings, and dissertations. Data were included from participants over 65 years of age with a diagnosis of probable dementia. A panel of vision experts evaluated the suitability of the candidate vision tests. The search yielded 179 publications that met the inclusion criteria. Of 134 vision tests that were identified, 19 were deemed suitable for screening by nurses in LTC. Tests screened for acuity (12), visual field (1), anatomy (2), color vision (2), and general visual abilities (2). Tests were excluded because of complexity of interpretation (90), need for specialized training (83), use in research only (57), need for specialized equipment (54), not assessing visual function (44), long test duration (21), uncommonness (13), and needing an act reserved for specialists (7). Psychometric properties were not often reported for tests. Few of the tests identified had been validated for use with individuals with dementia. Based on our review, few tests were deemed suitable for use by nurses to assess this population in LTC. Identifying appropriate tools to screen vision in individuals with dementia is a necessary first step to interventions that could potentially improve functioning and quality of life.
视力障碍在长期护理（LTC）中的痴呆症患者中普遍存在，但诊断不足。有效的筛查工具可以识别可纠正的视力问题。本范围综述旨在确定用于痴呆症患者的视力筛查测试，并评估其由 LTC 护士管理的适用性。使用 Arksey 和 O'Malley（2005）方法进行文献检索，包括研究文章、会议记录和论文。数据包括 65 岁以上且被诊断为可能患有痴呆症的参与者。一组视力专家评估了候选视力测试的适用性。搜索产生了 179 篇符合纳入标准的出版物。在确定的 134 项视力测试中，有 19 项被认为适合 LTC 护士进行筛查。测试筛查了视力（12 项）、视野（1 项）、解剖结构（2 项）、色觉（2 项）和一般视觉能力（2 项）。由于解释复杂（90 项）、需要专门培训（83 项）、仅用于研究（57 项）、需要专门设备（54 项）、未评估视觉功能（44 项）、测试时间长（21 项）、不常见（13 项）以及需要专家保留的行为（7 项），测试被排除在外。很少有测试报告其心理测量特性。确定的测试中很少有经过验证可用于痴呆症患者。根据我们的综述，很少有测试被认为适合护士用于评估 LTC 中的这一人群。确定适当的工具来筛查痴呆症患者的视力是干预措施的必要第一步，这些干预措施可能会提高他们的功能和生活质量。
