Abstract
Purpose :
Individuals with greater visual field (VF) loss from glaucoma are more likely to have difficulty with instrumental activities of daily living (IADLs). Here, we examined the association between home hazards and difficulty in preforming home-based IADLs.
Methods :
Participants included adults with primary glaucoma or suspect glaucoma. VF data were integrated to calculate binocular field integrated visual field (IVF) sensitivity. The Home Environment Assessment for the Visually Impaired (HEAVI) was used to assess environmental hazards, and the level home lighting was calculated. IADLs were evaluated using a validated questionnaire and home-based IADLs were analyzed. Simple and multivariable ordinal logistic regression models were used to evaluate the association between the frequency of home hazards/average home lighting and IVF with difficulty performing home-based IADLs.
Results :
Mean age was 71 years (n=173) and 46% of participants were female. 29% of individuals reported difficulty with 1 IADL and 9% reported difficulty with 2 or more IADLs. In simple regression models, each increment of 1 log unit brighter lighting was associated with a 63% decrease in the number of IADLs that participants reported difficulty performing (OR=0.36, 95% CI: 0.13-0.99, p=0.049). There was no association between frequency of home hazards and IADL difficulty. In multivariable models, each 5 dB decrement in IVF was associated with a 55% increase in the number of IADLs reported difficult (OR=1.55, 95% CI: 1.01-2.37, p=0.046). However, when light level was added to this model, the results were no longer statistically significant (OR= 1.52, 95% CI: 1.00-2.32, p=0.052). Home hazard frequency did not change the association between IVF damage and IADL difficulty (OR=1.55, 95% CI: 1.01-2.37, p=0.047).
Conclusions :
Home-related environmental hazards such as the level of lighting may partially mediate the relationship between VF loss and difficulty with home-based IADLs. Further studies are needed to investigate the effect of environmental factors on the completion of IADLs in individuals with glaucoma.
This is a 2020 ARVO Annual Meeting abstract.