title: Dual Sensory Impairment and Cognitive Decline: The Results From the Shelter Study.
abstract: OBJECTIVE
  To examine whether nursing home residents with concurrent vision and hearing impairment, dual sensory impairment (DSI), have a greater cognitive decline over time than do those without sensory impairment and whether social engagement modifies this association.
  
  
  METHODS
  Based on the Services and Health for Elderly in Long TERm Care study, 1,989 nursing home residents who were assessed using the interRAI LTCF at 6-month intervals over 1 year were included. Multivariate linear regression models with time-variant exposure variables of sensory impairment and social engagement using generalized estimating equations were performed to predict cognitive function measured by the Cognitive Performance Scale (range 0-6).
  
  
  RESULTS
  Residents with DSI had a greater cognitive decline [changes in Cognitive Performance Scale over 1 year = 1.12 (95% confidence interval = 0.81:1.42)] compared to those with either vision or hearing impairment [0.67 (0.53:0.64)] and those without sensory impairment [0.56 (0.48:0.64)]. A lower level of social engagement was also associated with a greater cognitive decline. The combined exposure variable of sensory impairment and social engagement revealed the greatest cognitive decline for socially disengaged residents with DSI [1.87 (1.24:2.51)] and the potential effect modification of social engagement on the association between DSI and cognitive decline; DSI was not associated with a greater cognitive decline among socially engaged residents, while it was associated among socially disengaged residents
  
  
  CONCLUSIONS
  Cognitive function declines faster in nursing home residents with DSI only when residents were not socially engaged. Therefore, residents with DSI might cognitively benefit from interventions to improve involvement in social life at nursing homes.
authors: Department of Geriatrics, First Faculty of Medicine, Charles University, Prague, Czech Republic. Department of Nursing, Faculty of Health Sciences, Palacky Univestiy, Olomouc, Czech Republic. yukari.yamada@upol.cz.
authors: Yukari
authors: Y
authors: Yamada
authors: AGAPLESION Bethesda Clinic, Competence Centre of Geriatrics, University of Ulm, Ulm, Germany.
authors: Michael D
authors: MD
authors: Denkinger
authors: Center on Aging, Catholic University of Sacred Heart, Rome, Italy.
authors: Graziano
authors: G
authors: Onder
authors: Research Unit Health-Environment-Ageing, Versailles- Saint-Quentin en Yvelines University, Paris, France.
authors: Jean-Claude
authors: JC
authors: Henrard
authors: EMGO Institute for Health and Care Research, Department of General Practice and Elderly Care Medicine, VU University Medical Centre, Amsterdam, The Netherlands. Elderly Care Research Unit at LUCAS and Center for Sociological Research, KU Leuven, Leuven, Belgium.
authors: Henriëtte G
authors: HG
authors: van der Roest
authors: National Institute for Health and Welfare, Helsinki, Finland.
authors: Harriet
authors: H
authors: Finne-Soveri
authors: Department of Geriatrics, First Faculty of Medicine, Charles University, Prague, Czech Republic.
authors: Tomas
authors: T
authors: Richter
authors: Department of Geriatrics, First Faculty of Medicine, Charles University, Prague, Czech Republic.
authors: Martina
authors: M
authors: Vlachova
authors: Center on Aging, Catholic University of Sacred Heart, Rome, Italy.
authors: Roberto
authors: R
authors: Bernabei
authors: Department of Geriatrics, First Faculty of Medicine, Charles University, Prague, Czech Republic.
authors: Eva
authors: E
authors: Topinkova
mesh_terms: D000368:Aged; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods; D034381:Hearing Loss / Q000150:complications / Q000523:psychology; D006707:Homes for the Aged / Q000706:statistics & numerical data; D006801:Humans; D007398:Interpersonal Relations; D016014:Linear Models; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data; D011379:Prognosis; D058992:Social Participation / Q000523:psychology*; D012944:Social Support; D013997:Time Factors; D014786:Vision Disorders / Q000150:complications / Q000523:psychology
keywords: Cognitive ageing; Dual sensory impairment; Nursing home.; Social engagement