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JL Istre-Walker, AT Broman, B Munoz, K Bandeen-Roche, KA Turano, GS Rubin, SK WestSEE Project Team; Is Vision Status a Predictor of Nursing Home Admissions in the Elderly? . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3837.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine whether visual function is a predictor of nursing home admissions among a population of community dwelling seniors. Methods: The Salisbury Eye Evaluation (SEE) is a longitudinal study of community dwelling seniors. SEE participants have completed three rounds of data collection (Round 1 1993-95; Round 2 1995-97; Round 3 1999-01). The outcome was admission to a nursing home (NH) between Round 2 and Round 3. Excluded from this analysis are participants who were admitted to nursing facilities before their Round 2 appointment or those who died without a nursing home admission. Binocular acuity was measured using ETDRS; mental status using the mini-mental state examination (MMSE), with higher scores reflecting better status; number of comorbidities as determined by self report and chart confirmation of eight conditions/diseases. A mobility score was calculated from four timed procedures: walking up/down a flight of stairs, balance and walking a 4 meter distance. Predictors were created using baseline (Round1) measurements and change between Round1 and Round2 measurements. Results: Of the 2,240 participants completing Round2 evaluations 108 participants had moved into a nursing home at the end of their Round 3 window (+/- 4 years from the Round 2 visit). After adjusting for age, gender, race and education, those with visual impairment (acuity worse than 20/40) were 2.1 times as likely to be admitted to a NH than those with no impairment (p=0.04). In a multivariate model NH admission was associated with MMSE, mobility and change in both over time. Age, gender, body mass index, and social support were also important. Best corrected acuity was not associated with NH admission after adjusting for cognitive and mobility scores. Conclusion: Those with visual loss were more likely to go into NH than those without visual loss. However, it may be the impact of vision on mobility and MMSE that leads to nursing home admission, rather than vision loss directly.
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