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Vanessa Shih, Joanna Campbell, Emily Beth Devine; The association between onset of self-reported vision impairment and nursing home residence in an older US population. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1576.
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© 2017 Association for Research in Vision and Ophthalmology.
Previous cross-sectional studies have found a negative association between vision function and individual burden measured by comorbidities and functional limitations. However, few longitudinal studies have examined the impact of onset of vision impairment. Using different methods, this study assessed the effect of transition to self-reported vision impairment on an individual’s likelihood of nursing home residence.
Ten waves of data from the Health and Retirement Study (1995-2012) were used for this study. Respondents’ self-reported vision status as poor or legally blind were used to define vision impairment. Unadjusted bivariate analyses and multivariable logistic regressions controlling for socio-demographic characteristics for 3 representative waves (1998, 2006, and 2012) estimated the association between vision impairment and nursing home residence. Mixed-effects logistic regressions with subject-specific random effects estimated the association between onset of vision impairment and nursing home residence.
Across the ten waves, 175,520 observations were collected on 35,042 respondents. The mean (standard deviation) age across the years of study was 67.0 (11.3) years. Prevalence of self-reported vision impairment and nursing home residence was 6.5% and 2.4%. In bivariate analyses, nursing home residence in vision impaired individuals was significantly higher than in individuals with no vision impairment (8.9% vs. 1.7%, p<0.001). In logistic analyses, the odds ratios for nursing home residence in the vision impaired, controlling for covariates, in 1998, 2006, and 2012 were 1.32, 1.01, and 1.25 (p=0.285, 0.975, and 0.329). After controlling for inter-subject heterogeneity in addition to covariates in mixed-effects models, transition to self-reported vision impairment within an individual was significantly associated with nursing home residence (OR=1.42, 95% CI: 1.10, 1.84, p=0.007).
In this longitudinal national survey of older Americans, using statistical techniques that accounted for unobserved heterogeneity, we have found the onset of vision impairment to significantly increase the risk of nursing home entry. Delaying the onset of vision impairment through early identification and improved treatment of conditions contributing to vision loss may increase the likelihood of individuals continuing to live independently in the community.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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