Self-reported vision impairment does not always predict disability in older adults when other factors are present
Vision typically declines as people age. Vision impairment makes it more difficult to drive, work, and to remain independent. However, the impact of poor vision on disability among the elderly (age 65 and older) is substantially reduced or eliminated when other health factors are taken into account, according to a new study. It found that when vision impairment did predict disability, it usually centered on doing highly visual activities at home, such as reading or watching television. The researchers obtained data on 6,550 individuals 65 years and older who participated in the National Health and Nutrition Examination Survey between 1999 and 2008. They paid particular attention to information on self-reported vision status, disability outcomes, coexisting conditions, and demographic details to examine the relationship between vision impairment and limitations in activities of daily living and participation in leisure activities. More than three-fourths of those studied reported having either good or better vision. Fair vision was reported by 18 percent and poor vision by 7 percent. Relative to their representation in the sample, rates of self-reported poor vision were greater for Black and Hispanic participants.
Greater proportions of persons reporting poor vision had problems with dressing, getting in and out of bed, and doing household chores compared to those with good vision. Nearly a third of those with poor vision (30.8 percent) reported being unable to attend social events. However, when other health conditions and variables were controlled in models, the effects of poor vision in reporting greater disability were reduced across all daily activities investigated. In fact, the effect of poor vision was completely eliminated for getting in and out of bed. The researchers do note, however, that those with poor vision are more than twice as likely as those with good or better vision to move into the next level of disability when it comes to going to social events and managing money. Performing leisure activities at home is also significantly affected by poor vision. These individuals are five times more likely to have greater disability. According to the researchers, vision rehabilitation interventions need to address multiple health dimensions, improve access to services, and establish connections with other agencies that serve the elderly. Their study was supported in part by AHRQ (T32 HS00011).
See "Self-reported vision impairment and its contribution to disability among older adults," by Bernard A. Steinman, Ph.D., and Susan M. Allen, Ph.D., in the Journal of Aging and Health 24(2), pp. 307-322, 2012.