Vision and Hearing Impairment in Aged Care Clients

PURPOSE: To determine the frequency of sensory impairments among aged care clients. METHODS: We examined 188 persons aged 65-99 years being evaluated for aged care services at a geriatric assessment center, west of Sydney, Australia. Visual acuity was measured using a LogMAR chart. Visual impairment was defined in the better eye: mild < 20/40 to > or = 20/80, moderate < 20/80 to > or = 20/200, and severe < 20/200. Hearing function was assessed by portable pure-tone air-conduction audiometry. Hearing loss was defined using average hearing thresholds in the better ear: mild > 25 to < or = 40 decibels (dB), moderate > 40 to < or = 60dB, and severe > 60dB. RESULTS: Vision, hearing, or both were randomly tested in 96, 93, and 49 aged care clients, respectively. Vision impairment was found in 30.2% of clients. Distance vision could be improved with pinhole in 16.7% of 84 clients with presenting VA < 20/20. Moderate to severe hearing loss was present in 50.5%. Combined sensory impairment was detected in 22.5% of persons having both tests. The age-standardized proportions with vision impairment was 25.6%, higher than the rate (17.4%) found in the Blue Mountains Eye Study (BMES) community population, but lower than the 37.7% prevalence reported from the BMES nursing home sample. Hearing impairment was also more common in aged care clients (28.1% vs 17.5%). CONCLUSIONS: This study suggests a high prevalence of sensory impairment among older persons transitioning from independent community living to institutionalized care.