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C. Stuen, M. Brennan, N. Oestreicher; The Societal Impact of Age-Related Macular Degeneration: Use of Social Support. Invest. Ophthalmol. Vis. Sci. 2008;49(13):2251.
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To evaluate the impact of age-related macular degeneration (AMD) on the use of social support by patients over an 18-month period
The study population comprised 384 AMD vision rehabilitation patients ≥65 years at Lighthouse International from 1998-2004. We evaluated binocular Snellen best corrected distance acuity (BCVA), functional vision (Functional Vision Questionnaire) and indices of social support from family and friends/neighbors. Separate indices were computed for instrumental support (support beyond basic self-care, e.g., help with shopping) and emotional support (e.g., advice). Assessments were at baseline and 6, 12 and 18 months post-baseline.
Mean raw BCVA scores increased and functional vision decreased steadily from baseline to 18 months over the study period. Mean values for the family instrumental support index increased from baseline (15.57 ± 7.91) to 6 months (immediately post-vision rehabilitation) (15.73 ± 8.02) and to 12 months (15.43 ±8.15) and achieved its highest level at 18 months (15.98 ± 8.13). Family emotional support index values decreased over the study period. At individual assessment timepoints, there was a statistically significant association (p-value<0.001) between poorer BCVA and functional vision status and greater use of family instrumental support. Patients with BCVA better than 20/70 who reported severe functional vision impairment received the highest levels of family instrumental support, whereas those with BCVA 20/200 or worse who reported mild impairment received the lowest levels. Poorer BCVA and functional vision were significantly associated with greater levels of family emotional support in at least 2 assessments (p-value<0.05). Levels of instrumental and emotional support from friends and neighbors were not associated with BCVA or functional vision status, nor did they change over time.
As BCVA and functional vision worsen in AMD patients over time, levels of instrumental assistance provided by families may increase to meet the needs of these patients. The worse BCVA and functional vision impairment in AMD patients, the greater the levels of instrumental and emotional support provided by their family members.
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