Table 3.
Impact of visual impairment on older people with dementia and their carers (Quantitative study)
| Study and Year | Study type | Type of impact | Reference group | Comparison group(s) | Effect measure | Size of effect | Confidence interval/ P value |
|---|---|---|---|---|---|---|---|
| Impact on older people with dementia and VI | |||||||
| Bennett, 2018 [16] | Cohort | Inpatient visit | VI and no dementia | VI and dementia | OR | 3.5 (CFA I) | 1.1–11.5 |
| 1.7 (CFA II) | 0.8–3.2 | ||||||
| Care workers’ service | VI and no dementia | VI and dementia | OR | 5.8 (CFA I) | 1.8–19.2 | ||
| 6.4 (CFA II) | 2.6–15.5 | ||||||
| Home care assistance | VI and no dementia | VI and dementia | OR | 4.4 (CFA I) | 1.3–15.0 | ||
| 3.4 (CFA II) | 1.3–8.5 | ||||||
| Bowen, 2016 [17] | Cross-sectional |
Activity of Daily Living impairment: Toilet/commode |
No VI or dementia | VI and dementia | OR | 2.19 (VA < 6/12) | 1.35–3.53 |
| 1.28 (VA < 6/18) | 0.71–2.28 | ||||||
| Eating | No VI or dementia | VI and dementia | OR | 1.75 (VA < 6/12) | 1.06–2.90 | ||
| 1.96 (VA < 6/18) | 1.03–3.82 | ||||||
| Dressing | No VI or dementia | VI and dementia | OR | 1.66 (VA < 6/12) | 1.11–2.49 | ||
| 1.2 (VA < 6/18) | 0.71–2.00 | ||||||
| Hygiene | No VI or dementia | VI and dementia | OR | 1.70 (VA < 6/12) | 1.13–2.54 | ||
| 1.46 (VA < 6/18) | 0.86–2.45 | ||||||
| Teeth | No VI or dementia | VI and dementia | OR | 1.86 (VA < 6/12) | 1.22–2.84 | ||
| 1.70 (VA < 6/18) | 0.99–2.9 | ||||||
| Telephone | No VI or dementia | VI and dementia | OR | 1.89 (VA < 6/12) | 1.26–2.85 | ||
| 2.08 (VA < 6/18) | 1.22–3.56 | ||||||
| Shopping | No VI or dementia | VI and dementia | OR | 1.63 (VA < 6/12) | 1.03–2.61 | ||
| 1.94 (VA < 6/18) | 1.07–3.54 | ||||||
| Finances | No VI or dementia | VI and dementia | OR | 1.7 (VA < 6/12) | 1.09–2.66 | ||
| 1.87 (VA < 6/18) | 1.06–3.30 | ||||||
| Transport | No VI or dementia | VI and dementia | OR | 1.91 (VA < 6/12) | 1.14–3.24 | ||
| 2.55 (VA < 6/18) | 1.29–5.08 | ||||||
| Deardorff, 2019 [23] | Cohort | Inpatient Admission | Dementia alone | Dementia + VI | OR | 1.82 | 1.17–2.82 |
| Dementia alone | Dementia +HI | OR | 1.03 | 0.80–1.52 | |||
| Dementia alone | Dementia + VI + HI | OR | 1.39 | 0.96–2.01 | |||
| Hospice Use | Dementia alone | Dementia + VI | OR | 1.18 | 0.50–2.76 | ||
| Dementia alone | Dementia +HI | OR | 1.39 | 0.65–3.01 | |||
| Dementia alone | Dementia + VI + HI | OR | 2.11 | 1.05–4.21 | |||
| Average Annual Total Healthcare Cost | Dementia alone | Dementia + VI alone | MD |
10,466 (REF) 11,671 (Comparison group) |
4600–23,812 9524–14,233 (P = 0.282) |
||
| Dementia alone | Dementia + VI + HI | MD |
10,466 (REF) 11,303 (Comparison group) |
4600–23,812 9524–13,291 (P = 0.395) |
|||
| Average Annual Medicare Fee-for-Service Cost | Dementia alone | Dementia + VI alone | MD |
3338 (REF) 3872 (Comparison group) |
851–13,097 2804–5374 (P = 0.364) |
||
| Dementia alone | Dementia + VI + HI | MD |
3338 (REF) 3505 (Comparison group) |
851–13,097 2637–4606 (P = 0.737) |
|||
| Kang, 2012 [28] | Cross-sectional | Social engagement | Dementia alone | Dementia + VI | Beta coefficient | β = −0.167 | P = 0.039a |
| Kiely, 2018 [29] | Cross-sectional analysis of longitudinal cohort study | NPI symptoms | No VI or dementia | Dementia alone | IRR | 1.63 | 0.73–3.63 |
| Dementia + VI | IRR | 7.08 | 1.41–35.43 | ||||
| Dementia + Dual sensory loss | IRR | 6.09 | 1.43–26.02 | ||||
| Patel, 2019 [38] | Cross-sectional | Activity Limitations | No VI or dementia | Possible dementia + VI | Predicted number of activity limitations: | 1.97 | 01.72–2.21 |
| Probable dementia + VI | Predicted number of activity limitations: | 2.28 | 2.03–2.53 | ||||
| Prince, 2011 [40] | Cross-sectional | Disability | Dementia alone | Dementia + VI | MD (WHODAS 2.0 scores) | Latin America: 6.5 | + 3.3 to+ 0.6 |
| China: −1.7 | −12.5 to+ 9.12 | ||||||
| India + 12.3 | + 5.4 to + 19.3 | ||||||
| Impact on carers | |||||||
| Varadaraj, 2020 [43] | Cross-sectional | Impact on valued activities | |||||
| Visiting friends and family | Dementia + VI | No VI or dementia | Percentage |
Reference: 36.5% Comparison: 12.6% |
P < 0.001 | ||
| Going out for enjoyment | Dementia + VI | No VI or dementia | Percentage |
Reference: 31.3% Comparison: 7.3% |
P < 0.001 | ||
| Attending religious services | Dementia + VI | No VI or dementia | Percentage |
Reference: 14.5% Comparison: 5.4% |
P < 0.001 | ||
| Participating in club meetings or group activities | Dementia + VI | No VI or dementia | Percentage |
Reference: 15.3% Comparison: 5.2% |
P < 0.001 | ||
| Supportive services directed to carers | |||||||
| Respite care | Dementia + VI | No VI or dementia | Percentage |
Reference: 18.6% Comparison: 7.2% |
P < 0.001 | ||
| Use of ≥1 supportive care | Dementia + VI | No VI or dementia | Percentage |
Reference: 29.5% Comparison: 13.1% |
P < 0.001 | ||
| Caregiving hours per month | Dementia + VI | No VI or dementia | IRR | 1.7 | 1.4–2.2 | ||
| Number of valued activities affected due to providing care | Dementia + VI | No VI or dementia | IRR | 3.2 | 2.2–4.6 | ||
Abbreviations: CFAS Cognitive Function and Ageing Studies, HI Hearing impairment, IRR Incidence Rate Ratio, NCDS Neurocognitive disorders (NCDs), NPI Neuropsychiatric Inventory, OR Odds Ratio, P P value, REF Reference group, VA Visual acuity, VI Visual impairment, WHODAS 2.0 WHODAS, World Health Organization Disability Assessment Schedule version 2.0, MD Mean difference
aafter adjustment for other covariates including Activity of Daily Life impairment, cognitive impairment, depression, anxiolytics and behavioral symptoms