title: Effectiveness of rehabilitation interventions in improving emotional and functional status in hearing or visually impaired older adults: a systematic review with meta-analyses.
abstract: OBJECTIVE
  To assess the effectiveness of non-equipment based rehabilitation interventions for older adults with an age-related hearing or visual impairment.
  
  
  METHODS
  We searched PubMed, EMBASE, PsychInfo, CINAHL, and the Cochrane Central Register of Controlled Trials.
  
  
  METHODS
  Two authors independently assessed trial eligibility, extracted data and assessed methodological quality. Controlled studies with more than 80% of participants aged ≥ 55 years and with rehabilitation interventions either separately or in combination with technical device provision were included. Meta-analyses were undertaken for the primary outcomes: emotional status, functional status, self-efficacy and social participation. All studies were categorized into 3 subgroups of intervention approaches (cognitive restructuring, education, and problem-solving), and subgroup analysis was performed.
  
  
  RESULTS
  Fourteen studies were identified: six on hearing impairment and eight on visual impairment, involving 1622 sensory impaired participants (mean age 70). Methodological quality of the studies was modest. Eight studies offered data for meta-analysis. No significant effects in favour of interventions on either emotional or functional status, self-efficacy, or social participation were found. In the subgroup analysis, only the problem-solving approach showed a positive effect on emotional status.
  
  
  CONCLUSIONS
  This review found no effects of non-equipment based rehabilitation interventions on emotional and functional status, self-efficacy, and social participation. However, subgroup analysis showed problem-solving as a potential effective approach for positively affecting emotional status.
authors.affiliation: Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands Kalorama Foundation, Beek-Ubbergen, the Netherlands lieve.roets-merken@radboudumc.nl.
authors.forename: Lieve M
authors.initials: LM
authors.lastname: Roets-Merken
authors.affiliation: Department of Neurosurgery, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Irena
authors.initials: I
authors.lastname: Draskovic
authors.affiliation: University Medical Centre Groningen, University of Groningen, the Netherlands.
authors.forename: Sytse U
authors.initials: SU
authors.lastname: Zuidema
authors.affiliation: Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre, the Netherlands Coma Science Group, Cyclotron Research Center and Neurology Department, University of Liège, Liège, Belgium.
authors.forename: Willemijn S
authors.initials: WS
authors.lastname: van Erp
authors.affiliation: Centre of Evidence-Based Practice, Department of Rehabilitation, Radboud University Nijmegen Medical Centre, the Netherlands.
authors.forename: Maud J L
authors.initials: MJ
authors.lastname: Graff
authors.affiliation: CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, Maastricht University, Maastricht, the Netherlands.
authors.forename: Gertrudis I J M
authors.initials: GI
authors.lastname: Kempen
authors.affiliation: Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands Kalorama Foundation, Beek-Ubbergen, the Netherlands.
authors.forename: Myrra J F J
authors.initials: MJ
authors.lastname: Vernooij-Dassen
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D004644:Emotions; D034381:Hearing Loss / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D016896:Treatment Outcome; D014786:Vision Disorders / Q000523:psychology* / Q000534:rehabilitation*
keywords: Aging; hearing impairment; rehabilitation interventions; systematic review; visual impairment