Aims and objectives: To examine the prevalence of hearing and vision impairments in 65+ year-old patients with hip fractures.
Background: Many older people believe sensory problems are inevitable and thus avoid medical assessment and assistance. Furthermore, health professionals often overlook sensory problems, though it is known that sensory impairments can increase the risk of falling and sustaining hip fractures.
Design: A prospective, observational study.
Methods: We admitted 544 consecutive patients to an orthogeriatric ward from October 2004-July 2006; 332 were screened for study inclusion with the Resident Assessment Instrument for Acute Care (InterRAI-AC) and a questionnaire (KAS-Screen). We conducted patient interviews, objective assessments, explored hospital records and interviewed the family and staff. Impairments were defined as problems with seeing, reading regular print or hearing normal speech.
Results: Sixteen per cent of the patients had no sensory impairments, 15.4% had vision impairments, 38.6% had hearing impairments and 30.1% had combined sensory impairments. Among the impaired, 80.6% were female, the mean age was 84.3 years (SD 6.8), 79.9% were living alone, 48.0% had cognitive impairments, 89.6% had impaired activities of daily living, 70.6% had impaired instrument activities in daily living, 51.0% had bladder incontinence and 26..8% were underweight. Comorbidity and polypharmacy were common. Delirium was detected in 17.9% on day three after surgery. Results showed the prevalence of combined sensory impairments was: 32.8% none; 52.2% moderate/severe; and 15.1% severe.
Conclusion: Patients with hip fractures frequently have hearing, vision and combined impairments.
Relevance to clinical practice: We recommend routine screening for sensory impairments in patients with hip fractures. Most sensory problems can be treated or relieved with environmental adjustments. Patients should be encouraged to seek treatment and training for adapting to sensory deficiencies. This approach may reduce the number of falls and improve the ability to sustain independent living.