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K.J. Cruickshanks, B.E. Klein, R. Klein, D.M. Nondahl; Two-Year Incidence of Disability in Older Adults: The Impact of Vision Impairment . Invest. Ophthalmol. Vis. Sci. 2003;44(13):986.
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Purpose: To evaluate the contribution of vision impairment to the development of disability in a population-based cohort of older adults. Methods: The 5-yr follow-up examination for the population-based Epidemiology of Hearing Loss Study (1998-2000) included, for the first time, questionnaire measures of disability (Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL) and the SF-36 Health-related Quality of Life). Hearing loss was assessed with pure-tone air and bone conduction audiometry. Visual impairment (current binocular visual acuity=20/40 or worse, best corrected visual acuity, better eye =20/40 or worse, and contrast sensitivity <1.55 log CS) was measured in 1998-2000 as part of the concurrent Beaver Dam Eye Study 10-yr follow-up examinations. Participants were re-interviewed two years later (N=2224). Results: In preliminary analyses, 7.5% of those without ADL impairments and 25.1% of those without IADL impairments at the 5-yr examination reported having impairments at the follow-up. After adjusting for possible confounders (age, sex, hearing loss, arthritis, other chronic diseases), impaired best corrected visual acuity was associated with the incidence of ADL impairments (OR=2.60, 95%CI=1.32,5.10). Impaired contrast sensitivity at the 5-yr examination was associated with the incidence of ADL (OR=1.71, 95%CI=1.11,2.61) and IADL impairments (OR=1.53, 95%CI=1.09,2.16). Participants with impaired contrast sensitivity had poorer scores at follow-up on the Physical Component Scale (PCS) of the SF-36 than participants with normal vision (44.5 vs 45.8, respectively, p=0.0025, adjusting for age, sex, hearing loss, arthritis, other chronic diseases, and the baseline PCS score). Conclusions: These preliminary data demonstrate that older adults with impaired vision are at higher risk for developing disabilities in a two-year period.
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