SENSE-Cog Asia: a feasibility study of a hearing intervention to improve outcomes in people with dementia

Sheikh, Saima, Tofique, Sehrish, Zehra, Nosheen, Amjad, Rabia, Rasheed, Maham, Usman, Maria, Lal, Shanker, Hooper, Emma, Miah, Jahanara, Husain, Nusrat, Jafri, Hussain, Chaudhry, Nasim and Leroi, Iracema (2021) SENSE-Cog Asia: a feasibility study of a hearing intervention to improve outcomes in people with dementia. Frontiers in Neurology, 12 . p. 654143.

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Background: There are few evidence-based non-pharmacological interventions adapted for people with dementia (PwD) in lower- and middle-income countries (LMIC). Thus, there is value in culturally adapting existing interventions from other settings. One such intervention for PwD involves hearing rehabilitation, which may improve dementia-related outcomes.

Objective: To culturally adapt and evaluate the feasibility and acceptability of a multi-faceted hearing support intervention to enhance quality of life in PwD for a LMIC setting, Pakistan.

Design: This was a study in three phases: (1) training and capacity building to deliver the study, including Patient and Public Involvement (PPI); (2) cultural adaptation of the intervention; and (3) delivery of a single-group feasibility study with a pre-test post-test design.

Setting: Home-based intervention, in two cities of Pakistan.

Participants: Adults aged ≥ 60 with mild-moderate dementia and uncorrected or partially corrected hearing impairment, and their study partners (n = 14).

Intervention: An adapted hearing support intervention (HSI) comprising a full assessment of hearing function, fitting of hearing aids, and home-based support from a “hearing support practitioner.”

Outcomes: Ratings of the feasibility of the study procedures, and acceptability/tolerability of the adapted intervention were ascertained through questionnaires, participant diaries, therapist logbooks and semi-structured interviews. A signal of effectiveness of the intervention was also explored using a battery of dementia-related outcome measures.

Results: Following cultural adaptation and capacity building for study conduct and delivery, we successfully implemented all intervention components in most participants, which were well-received and enacted by participant dyads. Acceptability (i.e., understanding, motivation, sense of achievement) and tolerability (i.e., effort, fatigue) ratings and safety of the intervention were within a priori target ranges. Recruitment and retention targets required improvement, due to the COVID-19 pandemic outbreak, as well as the lack of a clear clinical diagnostic pathway for dementia in both sites. Areas for future modification were clearly identified, including: the assessment/delivery logistics circuit; procedures for arranging visits; communication among referring clinicians and the study team.

Conclusion: This is the first study in a LMIC of sensory enhancement to improve dementia outcomes. Positive feasibility, acceptability and tolerability findings suggest that a full-scale effectiveness trial, with certain modifications is warranted.

Item Type: Article
Journal / Publication Title: Frontiers in Neurology
Publisher: Frontiers Media
ISSN: 1664-2295
Departments: Institute of Health > Rehabilitation and Sport Science
Additional Information: This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY).
Depositing User: Insight Administrator
SWORD Depositor: Insight Administrator
Date Deposited: 03 Sep 2021 10:48
Last Modified: 14 Mar 2023 16:30


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