Self-Reported Visual Function and Related Quality of Life in Middle-Aged and Older Adults from an Urban Census District of Parintins, Brazilian Amazon Region

Abstract

 

Purpose

 

To assess self-reported visual function and related quality of life in middle-aged and older adults from an urban census district of the city of Parintins, Brazilian Amazon Region.

 

Methods

 

An urban census sector was conveniently chosen for its proximity to the eye clinic for ophthalmic assessment. Subjects were enumerated through a door-to-door survey and those aged 45 years and older were invited for measurement of presenting (PVA) and best-corrected visual acuity (BCVA) for both near and distance and an ocular examination. PVA and BCVA were assigned into 4 categories (≥20/32; 20/40-20/63; 20/80-20/160; <20/200). The WHO 20-item International Visual Functioning Questionnaire (VFQ) was administered in individual interviews. VFQ validation was provided by examining internal consistency of responses to subscale questions as measured by Cronbach’s alpha statistic. The association of VFQ scores with PVA and socio-demographic variables was assessed.

 

Results

 

A total of 178 eligible persons in 136 households were enumerated, and 144 (80.9%) examined. From the 144 examined, 137 (77.0%) were interviewed (61 males and 76 females). Subscales for visual functioning - VF (general vision, distant vision, near/intermediate vision, sensory adaptation) and quality of life - QOL (pain, social/work activities, mental status) had internal consistency of responses of .90 and .77, respectively. VF and QOL subscale scores were closely correlated with PVA for both distance and near (VF - Spearman correlation coefficients of .43 for distance and 0.35 for near and QOL - .35 for distance and .29 for near; p<0.0001. In those with PVA deficit (<20/40) for distance (n=41) and aged 70 years and older (n=21), one line of improvement in PVA resulted in an 8.6 improvement in VFQOL total score.

 

Conclusions

 

In this small urban area of Parintins, self-reported visual function and vision-related quality of life could be assessed by the WHO-20 item International Visual Function Questionnaire. Negative correlation was found between vision impairment severity and both visual function and vision-related quality of life. In elderly adults aged 70 and older a dramatic improvement was noticed in VFQOL scores with just one line of improvement in VA. This finding reinforces the need of access to cost-effective interventions such as cataract surgery in this elderly population.

 

Keywords: 669 quality of life • 464 clinical (human) or epidemiologic studies: risk factor assessment • 754 visual acuity