Depression, combined visual and hearing impairment (dual sensory impairment): a hidden multi-morbidity among the elderly in Residential Care in India

To report the prevalence of depression and its association with combined visual (VI) and hearing impairment (HI) in the elderly in residential care in India. Participants aged >= 60 years were recruited from 41 homes. Data on personal and sociodemographic information were obtained. Visual acuity was measured using the logMAR chart. Patient Health Questionnaire (PHQ-9) was used to assess depression, and the Hearing Handicap Inventory for the Elderly Screening (HHIE) was administered to assess hearing status. Data of all 867 eligible elderly participants were analysed. The mean age of the participants was 74.2 years (standard deviation: 8.2 years) and included 537 (61.9%) women and 117 (13.5%) participants who had no education. The prevalence of depression was 60.0% (95% CI: 45.2-73.4) in the elderly with combined VI and HI compared to 20.9% (95% CI:14.4-28.8) among those with VI only and 37.8% (95% CI: 26.6-46.5) among those with HI only. On multiple logistic regression analyses, depression was approximately 5 times higher among the participants with DSI after adjusting for other covariates. Six out of ten elderly with combined HI and VI had depression highlighting the need for screening and referral when elderly present with combined vision and hearing loss.