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M. Baum, M. Gordon, M. Perlmutter, A. Coleman, H. Hollingsworth, M. Kass; Distance Visual Acuity of 20/40 or Worse Associated With Decreased Participation in Daily Activities . Invest. Ophthalmol. Vis. Sci. 2005;46(13):1906.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:A pilot study to examine whether lower binocular distance visual acuity is associated with lower activity participation among independent living, community dwelling older adults. Methods: Trained, certified occupational therapy students conducted in–home assessments of community dwelling adults aged 62 and older. Participants (n=89) were recruited from: a. systematic sample of the membership roster of a voluntary organization (n=68), b. stroke rehabilitation unit (n=15) and c. Barnes Retinal Institute (patients diagnosed with age–related macular degeneration, n=6). Measures included binocular VA tested with their usual correction in ambient and optimal lighting (ETDRS distance VA, Lighthouse near VA), Geriatric Depression Scale, Short Blessed, Simple Audition Test, and activity participation as determined by the Activity Card Sort. The sample was grouped by binocular distance VA < 20/40 or better than 20/40. Covariance analysis was used to estimate the association of binocular distance VA with activity participation adjusting for age, gender and the presence of depression, hearing loss, or cognitive impairment. Results:Mean age was 74 + 7.2 years, 64% were female, 94% were self–identified White and 57% were married. Forty percent (36 of 89) were classified as having binocular distance VA of < 20/40 when measured in ambient light. On the activity participation scale from low 0 to high 70, the mean activity participation score for participants with binocular distance VA of <20/40 was 35 + 15 SD compared to 46 + 15 SD (p=0.04) among participants with VA better than 20/40. The association of binocular VA <20/40 with lower activity participation was observed consistently across all groups including those with mild depression, mild cognitive impairment or mild hearing loss. Conclusions: Binocular distance VA of < 20/40 measured with usual correction under ambient home lighting was associated with lower participation of older adults in instrumental activities of daily living, leisure and social activities and appears additive to the negative effects of depression, cognitive loss and hearing loss on activity participation. A larger, more representative sample is needed to replicate these results.
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