Abstract
Purpose :
The number of older adults affected by both visual impairment (VI) and dementia will increase due to aging of the population. Using data from a nationally-representative panel study, we sought to determine the impact of comorbid VI and dementia on activity limitations among older Americans. These findings will help inform interventions to address functional decline in this population.
Methods :
Data from 2011-2016 from the National Health and Aging Trends Study, a nationally representative survey of Medicare enrollees age ≥ 65, were used to determine VI, dementia, and limitations in activities of daily living, instrumental activities of daily living, and mobility. VI was defined as self-reported difficulty recognizing someone across the street. Dementia was determined by the results of cognitive tests of memory, orientation, and executive function. Activity limitations were calculated by counting the number of activities for which participants required assistance from another person due to poor health or functioning. Multivariable regression was used to model the interaction between VI and dementia (Figure 1) to predict activity limitations, while adjusting for potential confounding factors and accounting for the complex survey design.
Results :
A total of 11,558 participants contributed 28,717 observations. The adjusted predicted number of activity limitations for respondents with only VI was 1.34 (95% CI: 1.21-1.48). The predicted number of activity limitations for those without VI but with possible and probable dementia was 1.24 (95% CI: 1.14-1.33) and 2.02 (95% CI: 1.84-2.19), respectively. Respondents with both VI and probable dementia had fewer activity limitations (2.28, 95% CI: 2.03-2.53) than expected based on the independent contribution of each of these conditions (Figure 2).
Conclusions :
Older adults with comorbid VI and dementia experienced a greater burden of activity limitations compared to those with only one of these impairments; however, probable dementia seemed to be the primary contributor. It is important to consider the impact of comorbidities like dementia when developing strategies to promote wellbeing for visually impaired older adults.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.