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Jesus Guerrero, Enrique O Graue-Hernandez, Alvaro Garcia Perez, Jesus Arrieta, Sandra Evelin Cardenas-Gonzalez, Aida Jimenez-Corona; Functional autonomy assessment in older patients with cataract using the Lawton and Barthel scales in a specialized hospital in Mexico City . Invest. Ophthalmol. Vis. Sci. 2016;57(12):6223.
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© ARVO (1962-2015); The Authors (2016-present)
Lack of autonomy related to disability in older people is widely recognized; however, less information is available about this condition and visual impairment. This study aimed to determine the level of functional autonomy in patients ≥50 years of age with clinically significant cataract.
Cross-sectional study carried out from November 2014 to July 2015, comprising 391 patients age ≥50 years with clinically significant cataract. Functional autonomy was evaluated through the Lawton questionnaire that examines instrumental activities of daily living (IADL), including the following 8 items: ability to use telephone, shopping, food preparation, housekeeping, laundry, mode of transportation, responsibility of own medication, and ability to handle finances. The score range from 0 (total) to 8 (without) and the level of dependency is classified as follows: without, mild, moderate, and total. The Barthel questionnaire was also applied, which evaluates the following 10 basic activities in daily living (BADL): feeding, bathing, grooming, dressing, bowels, bladder, toilet use, transfer (bed to chair and back), mobility, and stairs. The score range from 0 (total) to 100 (without) and the level of dependency is classified as follows: without, mild, moderate, severe, and total (score <20). All analyses were performed using Stata 13.
Of 391 patients (242 women and 149 men; average age 71.6 years, S.D. 10.2), 227 had moderate/severe visual impairment and 164 were blind. With respect to IADL, 20.9% had mild, 9.7% moderate, and 4.2% total dependency. As for BADL, 18.7% had mild, 3.0% moderate, and 2.5% total dependency. In multiple logistic regression analyses, after adjustment for sex, hypertension, and diabetes, dependency on IADL and BADL were associated with age ≥70 years (OR=3.44 [95%CI 1.71-6.90] and OR=7.65 [95%CI 1.72-33.9], respectively) and blindness (OR=1.55 [95%CI 0.86-2.80] and OR=2.19 [95%CI 0.88-5.45], respectively).
Adult patients with blindness caused by cataract are at higher risk of having lower functional autonomy; therefore, a multidisciplinary management to improve the autonomy of these patients should be implemented.
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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