title: Impact of dual sensory impairment on onset of behavioral symptoms in European nursing homes: results from the Services and Health for Elderly in Long-Term Care study.
abstract: OBJECTIVE
  To investigate if dual sensory impairment (DSI) in the form of a combined visual and hearing impairment is associated with the onset of behavioral symptoms in nursing homes.
  
  
  METHODS
  A total of 1524 nursing home residents without behavioral symptoms at baseline followed for 12 months in 59 nursing homes from the Czech Republic, England, Finland, France, Germany, Israel, Italy, and The Netherlands. The interRAI instrument for long-term care facilities was assessed by trained staff at baseline and 12 months later.
  
  
  RESULTS
  Altogether, 11% of residents had a new onset of behavioral symptoms (wandering, verbal abuse, physical abuse, socially inappropriate behavior, public disrobing, and resisting care) at 12-month follow-up. In multivariate analyses adjusted for potential confounders, DSI residents had significantly higher incidence of new behavioral symptoms at 12-month follow-up, irrespective of the severity of vision and hearing impairments [odds ratio (OR) = 2.1, 95% confidence interval (CI) = 1.3:3.4 for mild DSI, OR = 2.5, 95% CI = 1.6:4.0 for moderate DSI, and OR = 2.1, 95% CI = 1.2:3.7 for severe DSI] compared with residents without sensory impairment. Among the different types of symptoms, only abusive behaviors were less likely to be associated with DSI.
  
  
  CONCLUSIONS
  This study provides evidence that DSI could play a significant role in the development of behavioral symptoms in nursing home residents. More attention should be paid to DSI even when each of vision and hearing function is only minimally impaired.
authors.affiliation: Department of Geriatrics, First faculty of Medicine, Charles University, Prague, Czech Republic; Department of Nursing, Faculty of Health Sciences, Palacky University, Olomouc, Czech Republic. Electronic address: yukari.yamada@upol.cz.
authors.forename: Yukari
authors.initials: Y
authors.lastname: Yamada
authors.affiliation: Agaplesion Bethesda Clinic, Geriatric Center Ulm/Alb-Donau, University of Ulm, Ulm, Germany.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Denkinger
authors.affiliation: Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica Sacro Cuore, Rome, Italy.
authors.forename: Graziano
authors.initials: G
authors.lastname: Onder
authors.affiliation: National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Harriet
authors.initials: H
authors.lastname: Finne-Soveri
authors.affiliation: EMGO Institute for Health and Care Research, Department of General Practice and Elderly Care Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Henriëtte
authors.initials: H
authors.lastname: van der Roest
authors.affiliation: Department of Geriatrics, First faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Martina
authors.initials: M
authors.lastname: Vlachova
authors.affiliation: Department of Geriatrics, First faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Tomas
authors.initials: T
authors.lastname: Richter
authors.affiliation: Center for Standards in Health and Disability, Research Authority, University of Haifa, Haifa, Israel.
authors.forename: Jacob
authors.initials: J
authors.lastname: Gindin
authors.affiliation: Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica Sacro Cuore, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bernabei
authors.affiliation: Department of Geriatrics, First faculty of Medicine, Charles University, Prague, Czech Republic.
authors.forename: Eva
authors.initials: E
authors.lastname: Topinkova
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D001526:Behavioral Symptoms / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D016001:Confidence Intervals; D005060:Europe; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006299:Health Services for the Aged; D006311:Hearing Disorders / Q000150:complications* / Q000175:diagnosis; D006707:Homes for the Aged; D006801:Humans; D008134:Long-Term Care; D008137:Longitudinal Studies; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D015999:Multivariate Analysis; D009735:Nursing Homes; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D012678:Sensation Disorders / Q000175:diagnosis / Q000453:epidemiology; D014786:Vision Disorders / Q000150:complications* / Q000175:diagnosis
keywords: Older people; behavioral symptoms; dual sensory impairment; nursing home