The effect of visual and hearing impairments on functional status
The effect of visual and hearing impairments on functional status
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DOI：
10.1111/j.1532-5415.1999.tb07432.x
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发表时间：
1999-11-01
影响因子：
6.3
通讯作者：
Potter, JF
中科院分区：
文献类型：
--
作者：
Keller, BK;Morton, JL;Potter, JF
目的：描述年老体弱者视觉和听觉障碍的患病率，并评估感觉障碍与整体功能状态之间的关系。设计：前瞻性患者评估和回顾性数据分析。地点：一所大学医学中心的门诊老年评估诊所。参与者：1986年至1992年在内布拉斯加大学医学中心门诊老年评估诊所就诊的视力和听力信息均可用的先天性患者（n = 576）。测量：通过Lighthouse近视力测试测量视力，并通过耳语测试评估听力。采用Lawton-Brody日常生活活动量表（ADL）和工具性日常生活活动量表（IADL）评定功能状态。共病分类的累积疾病评定量表，和精神状态进行了评估的Folstein迷你精神状态Exam.RESULTS：百分之十八的患者视力损害20/70或更糟。64%的患者存在听力障碍。视力高于20/70的患者的平均ADL和IADL评分分别为20/24和12/23，而视力受损患者的平均ADL和IADL评分分别为18/24和8/23（两项比较P <0.001）。听力正常者的ADL和IADL评分也高于听力受损者：分别为21/24和19/24（P <0.001），13/23和11/23（P <0.001）。视力和听力对IADL评分的影响与精神状态和共病无关（P <0.001）。视力对ADL评分的影响与精神状态和共病无关（P <0.001），而听力对ADL评分的影响则与精神状态和共病无关。听力和视力受损的受试者的平均IADL（P < = .05）和ADL（P < = .05）得分显着低于那些没有impairment.CONCLUSIONS：视力和听力障碍是常见的，在这个虚弱的老年门诊人群。如通过IADL和ADL评分测量的功能状态对于感觉受损的受试者是减少的。视觉和听觉联合损伤对功能的影响比单一感觉损伤更大，并影响独立于精神状态和共病疾病的功能状态。总的来说，这些结果表明，改善感觉功能的干预措施可能会改善功能独立性。
OBJECTIVES: To describe the prevalence of visual and auditory impairment in frail older persons and to evaluate the association between sensory impairment and overall functional status.DESIGN: Prospective patient evaluation and retrospective analysis of data.SETTING: The outpatient geriatric assessment clinic of a university medical center.PARTICIPANTS: Consecutive patients seen in the University of Nebraska Medical Center Outpatient Geriatric Assessment Clinic from 1986 to 1992 for whom both vision and hearing information were available (n = 576).MEASUREMENTS: Visual acuity was measured by the Lighthouse Near Visual Acuity Test, and auditory acuity was evaluated with the whisper test. Functional status was determined by Lawton-Brody activities of daily living (ADL) and instrumental activities of daily living (IADL) scales. Comorbid illness was classified by the Cumulative Illness Rating Scale, and mental status was assessed by the Folstein Mini-Mental State Exam.RESULTS: Eighteen percent of patients had visual impairment of 20/70 or worse. Hearing impairment was found in 64%. The mean ADL and IADL scores were 20/24 and 12/23, respectively, for patients with visual acuity better than 20/70, compared with 18/24 and 8/23 for visually impaired patients (P < .001 for both comparisons). ADL and IADL scores were also higher in hearing intact patients compared with those with hearing impairment: respectively, 21/24 vs 19/24 (P < .001) and 13/23 vs 11/23 (P < .001). The effects of visual acuity and hearing acuity on IADL score are independent of mental status and comorbid illness (P < .001). The effect of visual acuity on ADL score is independent of mental status and comorbid illness (P < .001), whereas the effect of hearing on ADL score is not. Subjects with both hearing and vision impairment had mean IADL (P < = .05) and ADL (P < = .05) scores significantly lower than those with no impairment.CONCLUSIONS: Impairments of vision and hearing are common in this frail older outpatient population. Functional status, as measured by IADL and ADL scores, is diminished for sensory impaired subjects. Combined vision and hearing impairments have a greater effect on function than single sensory impairments and influence functional status independent of mental status and comorbid illness. Overall, these results suggest that interventions to improve sensory function may improve functional independence.