Recently published guidelines (1) relating to sight tests among people with dementia go some of the way to addressing the specific needs of this group. However, there is still a long way to go in terms of improving the provision of eye care services and optimising the visual health of this group, says a new study published today by Thomas Pocklington Trust (2).
The study (3) – The development of professional guidelines for the eye examination of people with dementia – was presented at the first ever national “Dementia and Sight Loss conference” in London (1st December) – a forum where 100 dementia and sight loss professionals met to discuss ways to tackle the challenge of concurrent dementia and sight loss (4).
The study, by researchers at the University of Bradford Schools of Optometry and Health Studies (3), reviewed procedures for sight tests and eye examinations among those with dementia. It found that policy and practice were hampered by a serious lack of basic research into concurrent dementia and sight loss and prompted recommendations which could lead to improved procedures, tools and techniques.
“Our study shows that professionals are working without the support of solid information,” said Ron Bramley, Chief Executive, Thomas Pocklington Trust. “The implications of having both dementia and sight loss are under- researched and too often ignored but we believe that discussions at today’s national conference will help to change that.”
An estimated 750,000 people in the UK live with dementia and over the next few decades this figure is set to increase. Of these, at least 100,000 will also have sight loss. People with dementia are potentially more at risk of visual impairment than people without dementia. Their visual acuity, contrast sensitivity and colour vision can be impaired, as well as their spatial awareness and perception of depth. Since their ability to cope with this sight loss is reduced by dementia, it has a far greater impact on their cognitive performance, mobility and daily living activities.
Despite this, few people with dementia appear to have access to regular eye tests. Promoting the fact that some optometrists make home visits could be vital, suggest the researchers, as is clear communication of the findings, not just to the person tested but to their family and/or professional carers.
More research is needed to help professionals choose the right testing and eye care for people with dementia. Determining which actions give the best results and when, specifically, people with dementia most benefit from them would be invaluable.
Recommendations prompted by the study outline seven steps towards improving policy and practice:
– Conduct a systematic study of the availability and uptake of sight tests among people with dementia.
– Set up a website for people with dementia and their carers with information on how dementia affects eye health, and the importance of eye examinations.
– Develop education and training for optometrists and care home staff.
– Compile a list of optometrists experienced in providing eye care for people with dementia.
– Develop a template for recording the results of eye examinations in people with dementia – something which can be endorsed by professional bodies and made available to care homes.
– Measure the effectiveness of eye care, such as sight tests and cataract removals, on the quality of life of people with dementia.
– Research clinical testing methods so that guidelines can be strengthened. Measuring contrast sensitivity, for example, in someone with dementia could be vital as an inability to judge contrasts can make daily tasks impossible.
Ron Bramley said: “The steps set out in this study show ways to meet the eye health needs of people with dementia that are both thorough and tailored to the individual. These steps could revolutionise the eye care of people with both dementia and sight loss.”
Notes:
1. College of Optometrists – here. Published August 2010
2. Thomas Pocklington Trust is a charity which aims to improve the quality of life of people with sight loss. It is a leading provider of housing, care and support services for people with sight loss in the UK, and is a major research and development body.
3. The findings of the study are included as part of a Thomas Pocklington Trust Research Discussion Paper number 8 – “Improving the provision of vision and eye health care to people with dementia” available from 1st Dec. here. The study was conducted by by Dr. Declan McKeefry (School of Optometry & Vision Science) and Dr. Ruth Bartlett (Division of Dementia Studies) from the University of Bradford.
4. The first national Dementia and Sight Loss Conference will be chaired by Baroness Sally Greengross.
5. The Conference is one initiative of the Dementia and Sight Loss Interest Group (DaSLIG) an alliance of the charities Royal National Institute of Blind People (RNIB), Alzheimer’s Society, Thomas Pocklington Trust and Arup (an independent firm including designers, planners and engineers). This special interest group leads work to raise awareness of joint dementia and sight loss and is part of VISION 2020 UK. For more information about DaSLIG visit the microsite here.
Source:
Thomas Pocklington Trust