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Heather Livengood, Elizabeth Skidmore, Richard Anthony Bilonick, Ian P Conner, Nancy Baker, Joel S Schuman; Examining functional ability and vision-specific quality of life in people with glaucoma. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1972. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
The distinction between functional ability and quality of life is ambiguous; yet, each likely contributes uniquely to understanding how glaucoma affects independence and disability. This cross-sectional study assessed functional ability and vision-specific quality of life (VSQoL) to test the hypotheses that (1) functional ability would have a positive correlation with VSQoL and (2) functional ability compared to VSQoL would have a stronger association with glaucoma severity.
We recruited community-dwelling adults 50 years and older with glaucoma (n=90) and measured glaucoma severity (mean deviation of the better-seeing eye), functional ability (Assessment of Life Habits), and VSQoL (25-item National Eye Institute Visual Function Questionnaire). Functional ability was measured by two methods: accomplishment (i.e., the usual way of performing daily life tasks) and satisfaction. We conducted a correlation analysis to explore the relationship between functional ability and VSQoL and regression analyses to compare the association of functional ability and VSQoL with glaucoma severity, controlling for covariates.
Participants on average had early stage glaucoma (M = -4.3 dB, 95% CI ,-5.7 to -2.9 dB), high functional ability (accomplishment, M = 9.3, 95% CI, 9.2–9.4; satisfaction, M = 4.5, 95% CI, 4.4–4.6) and high VSQoL (M = 84.0, 95% CI, 81.3-86.8). Functional ability (accomplishment and satisfaction) had moderate correlations with VSQoL (rho = .61 and .62, P < .001, respectively). Regression analyses indicated that accomplishment (β = .34, P = .01) was a statistically significant indicator of glaucoma severity. Categorizing functional ability by activity (ability at individual level) and participation (ability at societal level), participation satisfaction (β = -.55) and VSQoL (β = .46) were statistically significant indicators (P ≤ .01) of glaucoma severity.
Our results indicated that functional ability is related to VSQoL and functional ability had a stronger association with glaucoma severity than VSQoL. Thus, measures of functional ability are important components in standard care. Current practice, which focuses primarily on visual system impairment, may be insufficient if it neglects measures of functional ability even in the early stage of glaucoma.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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