Delivering a hearing and vision support intervention for people with dementia: looking "under the hood" of the SENSE-Cog trial pre- and during the COVID-19 pandemic

Disabil Rehabil. 2026 May 29:1-23. doi: 10.1080/09638288.2026.2676067. Online ahead of print.

Abstract

Purpose: Acceptable hearing and vision rehabilitation is needed to improve quality of life for people with dementia (PwD) living at home. We examined delivery and uptake of SENSE-Cog, a complex sensory support intervention (SSI), within a European multicentre randomised controlled trial.

Materials and methods: PwD with hearing and/or vision loss were randomised to an 18-week home-based SSI or sensory care-as-usual. A mixed-methods design included assessments at baseline, 18 and 36 weeks and qualitative interviews with Sensory Support Therapists (SSTs). Reporting followed TIDieR. COVID-19 restrictions necessitated a streamlined SSI. Trial registration: ISRCTN17056211.

Results: The trial enrolled 252 dyads (PwD + study partner). In the active arm (n = 124), fidelity-completion of all primary components-was 60% (75/124); participants received a mean of 6.3 SST visits. Of 124 assessed for hearing loss, 101 (81%) were prescribed hearing aids with acceptable adherence (Likert mean 3.85/5). Among those receiving vision assessment, 43 (35%) were prescribed glasses, with reported use of 4-8 h/day. Greater cognitive impairment was associated with more SST contact (higher "dose").

Conclusions: Fidelity of the SSI was variable but appeared appropriately tailored, with higher intervention dose in those with greater cognitive impairment. Care partners were central in supporting sensory health-related behaviour change.

Keywords: Dementia; complex intervention; hearing impairment; sensory rehabilitation; vision impairment.