Controlled trial shows hearing and vision health support vital in dementia care

A new study across five European countries is the largest randomized controlled trial to date evaluating the efficacy of a combined hearing and vision rehabilitation intervention for people with dementia living at home. The new study led by Trinity College and the Global Brain Health Institute (GBHI) is published in The Lancet’s Healthy Longevity journal.

The SENSE-Cog trial highlights the critical need to support hearing and vision health in people living with dementia and shows the positive short-term impact on quality of life of hearing and vision interventions.

The study was a randomized controlled trial of hearing and vision rehabilitation for people with dementia in five countries across Europe (Cyprus, France, Greece, Ireland and the UK). The trial evaluated the clinical impact of a tailored Sensory Support Intervention (SSI) that provided hearing and vision rehabilitation on quality of life (QoL) and other outcomes in people with mild-to-moderate dementia and concurrent sensory difficulties.

The intervention showed significant improvements in quality of life in the short term. However, the difference in quality of life between those who received the intervention and those who did not was not evident in the longer term (further research is required here). The research points to the widespread prevalence of sensory difficulties among people with dementia, affecting up to 70% of this population. These difficulties, if unaddressed, can exacerbate cognitive decline and worsen overall well-being.

Few studies exist of pragmatic, non-pharmacological interventions for dementia across regions of differing language and health systems. As Europe prepares to launch new amyloid-targeting therapies for Alzheimer’s disease, the study’s findings highlight the importance of continuing to investigate non-drug interventions, particularly for individuals with advanced dementia or non-Alzheimer’s forms of the disease, who may not benefit from these new treatments.

Professor Iracema Leroi, the study’s principal investigator from the Global Brain Health Institute and School of Medicine, Trinity College Dublin, emphasized, “These results are promising and suggest that small, cost-effective interventions such as hearing aids and glasses may impact quality of life in people with dementia. Studies like this argue strongly for ongoing support of non-drug interventions in dementia as important areas for further research.

“Hence, the focus on QoL and living well with dementia is paramount, supporting our choice of quality of life as our main outcome. This approach is crucial because, with the advent of disease-modifying therapies for Alzheimer’s disease the focus of dementia research is increasingly on prevention and efforts to slow progression, at the potential expense of efforts to support quality of life for the 55 million people worldwide who already have established dementia.”

Professor Brian Lawlor, Conolly Norman Professor of Old Age Psychiatry and Site Director of the Global Brain Health Institute, Trinity College Dublin, said, “Hearing and vision difficulties represent a significant unmet need in people with dementia. This was the first large-scale study to explore whether a hearing and vision intervention could improve the quality of life for people with dementia, demonstrating that such an intervention could be developed and delivered even during the COVID-19 pandemic. The early indications of improved quality of life underscore the need for further research in this important area.”

This is the first fully powered randomized controlled trial of hearing and vision rehabilitation in people with mild to moderate dementia, providing the best evidence to date on such interventions for improving dementia-related quality of life in the shorter term. The research team would suggest that further evidence is needed to understand the impact on cognition, neuropsychiatric symptoms and family care partner role.

The study calls for continued efforts to develop and refine non-pharmacological strategies that address the complex needs of people with dementia, ensuring a holistic approach to their care.

More information:
Iracema Leroi et al, Hearing and vision rehabilitation for people with dementia in five European countries (SENSE-Cog): a randomised controlled trial, The Lancet Healthy Longevity (2024). DOI: 10.1016/j.lanhl.2024.07.008