The National Institute for Health Research (NIHR)’s Prevalence of Visual Impairment in People with Dementia (PrOVIDe) study investigated the prevalence of visual impairment in people with dementia, and addressed possible reasons behind any under-detection or inappropriate management of vision problems in this patient group.
No evidence was detected that the management of visual impairment in people with dementia differed from that in other older people generally, although the prevalence of visual impairment does tend to be higher in people with dementia living in care homes. Carers and care workers may underestimate how much can be achieved by eye examinations. People with dementia (and their carers) are frequently unaware of the availability of domiciliary sight tests.
Improved communication between optometrists and carers / patients is recommended, permitting optometrists to be duly informed about each person’s dementia. Eye examinations could then be adjusted to individual needs, allowing extra time etc. Optometrists may require training and guidance about dementia.
Around 50% of cases with visual impairment are correctable with spectacles or cataract surgery. Improvements to the quality of life in people with dementia achievable by correcting visual impairments may sometimes need to be balanced against the individual risks / burdens involved in undergoing examinations or cataract surgery.
Development of an eye-care pathway for people with dementia is discussed. Further research might assess the likely benefits of early cataract surgery and the role of specialist optometrists for older people.
Bowen, M. Edgar, DF. [and] Hancock, B. [et al] (2016). The Prevalence of Visual Impairment in People with Dementia (the PrOVIDe study): a cross-sectional study of people aged 60–89 years with dementia and qualitative exploration of individual, carer and professional perspectives. Southampton (UK): NIHR Journals Library, Health Services and Delivery Research, July 2016, No. 4.21. There is also an Executive Summary.
NIHR Signal: One Third of People With Dementia May Have Treatable Vision Problems (NIHR Signal)
An expert commentary relating to this study highlights the estimate that there could be 10,000 people in the UK with dementia who are wearing the wrong prescription glasses, and approximately 50,000 people in the UK with dementia and an untreated cataract.
Murray, M. (2016). A third of people with dementia have treatable vision problems. London: National Institute for Health Research Signal (NIHR Signal), September 27th 2016.