Vision, hearing, and dementia in older adults receiving home care services: implications for optometric practice

Vision and hearing impairments are common in older adults and are often comorbid with dementia. These conditions exacerbate the impact of dementia, and outcomes for those with dual sensory impairment are considerably worse than for people with single sensory impairment. This narrative review synthesises current evidence on the intersection of vision, hearing, and cognitive impairment, outlining prevalence, and psychosocial, physical, and functional consequences of sensory loss in older populations. Many Australians with dementia age in place; however, sensory interventions are often underutilised in home-based aged care settings, despite benefits for quality of life, responsive behaviours and functioning in daily life. Barriers to effective vision and hearing care include a lack of routine sensory assessments, limited integration of optometry and audiology services in home care packages, and insufficient training of home care staff. Dementia- and hearing impairment-friendly eyecare, embedded within person-centred, interdisciplinary models, is essential to accommodate cognitive and hearing needs. Optometrists are well-positioned to lead these efforts, particularly through home-based services that support ageing in place. Implementation of national and international recommendations for integrated sensory care could enhance quality of life, independence, and cognitive health in older adults.