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Vincent Daien, Karine Peres, Max Villain, Alain Colvez, Cécile Delcourt, Isabelle Carrière; Association Of Visual Impairments With Activity Limitation In Elderly And The Potential Impact Of Optimal Optical Correction : The Pola Study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4225.
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Activity limitations, which induce autonomy loss in the elderly, are a major public health problem. We estimated the associations between objectively measured visual impairments and activity limitations and the proportion of limitations that could be prevented by appropriate optical correction.
The study sample consisted of 1 815 people aged 63 years and over from a population-based cohort. Distance visual acuities were measured with the usual optical correction and with the best achieved correction. "Low distance vision" was defined as vision lower than 0.5 logMAR in both eyes and "Socially Significant Visual Impairment" (SSVI) includes subjects failing to achieve the minimum vision standards for driving. Multivariate logistic regressions were used to estimate the cross-sectional associations between visual functions and Instrumental Activities of Daily Living (IADL) limitations. We estimated the generalized impact fraction (GIF) representing the proportion of persons with IADL that could be prevented with the best optical correction.
After adjustment for potential confounders, low distance vision in both eyes and SSVI were associated with more IADL limitations than normal distance visual acuity (odds ratio (OR), 3.12; 95%CI, 1.67-5.84 and OR, 1.73; 95%CI, 1.02-2.84 respectively). Overall, 39.9% of patients had an inappropriate optical correction. The overall GIF was 20% (95% CI, 13-29).
Objectively measured visual functions are strongly associated with IADL-limitations. The simple prescription of the best achieved visual correction could prevent IADL-limitations in one fifth of the cohort. Programs providing corrective optical services in elderly populations may contribute to maintaining autonomy.
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