الفهرس 
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Abstract
Vision, hearing, olfaction, and cognitive function are essential components of healthy and successful ageing. In the elderly, age-related changes, including vision, hearing and olfactory impairments occur. Sensory impairments affect the elderly individual’s activities of daily living, including independence, social participation, health-related quality of life, and mental health. Hearing impairment is the most common sensory deficit with prevalence reported to be as high as 64.1% in the population age above 65 years old. Visual impairment occurs in 9% to 18% of the elderly. Apart from presbyopia, which is considered to be a universal age-related vision change, cataract, glaucoma, and macular degeneration are very common visual problems in the elderly.
The primary aim of this study was to determine the prevalence of sensory, functional and cognitive decline in elderly patients, while the secondary aim was to assess the impact of sensory impairment on functional and cognitive decline in elderly patients.
Participants in this study were classified into two groups each group consisting of 200 cases.
group one consisted of individuals with sensory impairment either affecting one organ or dual sensory impairment or more, group two consisted of those individuals not having any sensory impairment.
Exclusion criteria were; history of bilateral cataract surgery and any other intraocular or refractive surgical procedure in either eye, illiteracy, or the presence of diagnosed dementia or Alzheimer disease or any mental and psychiatric disorder affecting cognitive function (Major depression and metabolism delirium ), total hearing loss were excluded due to absence of modification in MMS examination.
Informed consent took from all patients, and all patients were subjected to detailed history taking including: Age, sex, educational level, smoking habits, vision, hearing or smell problems, history of trauma and or fall, medication intake, presence of any other diseases (cardiovascular risk factors – diabetes, smoking, high cholesterol, and hypertension).
Visual acuity was measured with correction (C.C) and without correction (S.C), the examination included also field of vision, tonometry and color vision, direct ophthalmoscope .Only phakic eyes included in the study. When both eyes are phakic, then the eye with the better VA was used for analysis. If both eyes had the same VA then the right eye was used for the data. (18) If the subject had undergone cataract surgery in one eye but their other phakic eye had the same or better VA, then the phakic eye was included, however, if the phakic eye had a worse VA than the operated pseudophakic eye, then the case was excluded from the study.
Auditory acuity was measured by pure-tone audiometry with speech discrimination.
Olfaction was evaluated by the odor Identification Test.
Cognition was assessed using the Mini Mental State Exam (MMSE) and the Geriatric Depression Scale (GDS-15).
Functional status was determined by the activities of daily living (ADL) and Instrumental Activities of Daily Living (IADL) scales.
Our results revealed with reminded that there was no statistical significant difference between two studied groups regarding age (age, sex, smoking, diabetes, high cholesterol, and hypertension) that:-
There was statistical significant difference between the two studied groups regarding (Mini Nutritional Assessment, Mini-Mental State, Geriatric depression scale, IADLs, ADLs).
There was a significant positive effect of sensory impairment (visual problems, hearing problems, olfactory problems) on Mini-Mental State Examination category.
There was a significant positive effect of sensory impairment (visual problems, hearing problems) on IADLs, ADLs.
On the other hand olfactory problems show insignificant effect on IADLs, ADLs.
There was a positive relation between MMS, ADLs and IADLs and the number of affection systems, it was found that the increasing in the affected system had a significant effect on all scores.
It was found also that the prevalence of cognitive abnormality in cases was 25.5% while in control was 13.5%.
The Prevalence of functional abnormality in cases was 33.5% while in control was 12%.
The prevalence of cognitive abnormality in cases with visual problems were 2o.6%, While the prevalence of cognitive abnormality in cases with hearing abnormality were 41.5%, and the prevalence of cognitive abnormality in cases with olfaction abnormality were 33.3%.
The prevalence of functional abnormality in cases with visual problems were 32.1%, while the prevalence of functional abnormality in cases with hearing abnormality were57.3%, and the prevalence of functional abnormality in cases with olfaction problems were 32.3%.