Eye care services for older institutionalised individuals affected by cognitive and visual deficits: a systematic...

The prevalence of dementia and ocular pathology increases with age and many older individuals affected by such diseases are being institutionalised. The objectives of this systematic review are to describe the level of eye care services being offered to older institutionalised individuals, present the prevalence of visual impairment in those with dementia, and describe the interventions offered to visually impaired residents with dementia.

A literature review was performed in four relevant databases, limited to peer-reviewed journals published in English and French, between the years 1984 and 2014. The review targeted individuals 65 years of age or older, residing in long-term care facilities/nursing homes and affected by dementia. Only relevant articles addressing at least one of the three objectives were retained for this review.

The literature search identified 440 abstracts that were all read by each of the authors. After consensus, 92 articles were identified as potentially relevant and read. In the end, 28 were found to address at least one of the three objectives and were kept for the review. The results indicated that eye care services for older institutionalised individuals are sub-optimal, that the prevalence of visual impairment remains high in that population, and that interventions such as optimising the ocular refraction, performing cataract surgery, providing low vision rehabilitation and adapting the environment can be beneficial to residents.

This systematic review demonstrated the benefits of providing regular eye care to long-term care facility/nursing home residents, including those at all levels of dementia. Additionally, it documented the benefits of various treatment modalities such as cataract surgery, staff training, environmental adaptations and visual rehabilitation for improving several aspects of the residents' quality of life. This review, however, has highlighted the fact that additional studies are required to strengthen the findings reported so far, and importantly, to evaluate the various treatment modalities described herein for residents in the most advanced stages of dementia.