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W.M. Jay, K.E. Hagerman, R.T. Williams, M.J. Robertson; Low Vision Rehabilitation in Patients With Visual and Cognitive Impairment . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4604.
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Purpose: The prevalence of visual and cognitive impairments increases with age. Patients may have simultaneous impairments both visual and cognitive. The purpose of this study was to evaluate the prevalence of cognitive impairment in a low vision clinic and to determine whether Low Vision Rehabilitation (LVR) strategies improve visual function in the cognitively impaired. Methods: We studied fifty consecutive patients presenting to a low vision clinic. All patients were evaluated using Folstein’s Mini Mental Status Examination (MMSE) to screen for cognitive impairment. During the low vision examination, visual acuity was measured with and without the use of optical low vision aids (LVA). The visual acuity improvement was calculated for each patient. All data was analyzed using Mann–Whitney and Pearson correlation statistical tests. Results: Of the 50 patients examined, 16 (32%) had an MMSE score less than 24 with a mean score of 20+/– 3.5. MMSE scores less than 24 are suggestive of cognitive impairment. There were no differences in gender, mean age, or mean visual acuity with and without devices between the patients with cognitive impairment and those without. 14/16 (87.5%) of the patients with cognitive impairment experienced an improvement in acuity using low vision devices. Their average acuity with LVA was 20/35+/–10 (Snellen Equivalent) improved from 20/103+/–65 without LVA. There was no correlation between MMSE and VA improvement (R2=0.144, p=0.319). Conclusions: 32% percent of patients in a low vision clinic had MMSE scores suggesting cognitive impairment. 87.5% of patients with visual and cognitive impairments experience an improvement in visual function with low vision aids. There is no correlation between cognitive function and visual acuity improvement with low vision aids. LVR strategies may be successfully provided to patients with visual impairments regardless of the presence of simultaneous cognitive impairments.
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