The relationship between fatigue severity and cognitive overload in adults with visual impairment.

Abstract

Purpose : Fatigue experienced by people with a visual impairment seems to be related to vision loss and has a negative impact on cognitive and emotional functioning, social roles, and participation. Qualitative research has indicated that people with visual impairment report a high cognitive load to compensate for vision loss, which appears to play an important role in feelings of fatigue. The relationship between fatigue severity and cognitive overload in adults with visual impairment was quantitatively examined in this cohort study for the first time.

Methods : Cross-sectional data (N=211, 61% female, mean age of 57±15), originating from the recruitment phase of the E-nergEYEze trial including participants with visual impairment in one or both eyes according WHO criteria, was used to determine the association between cognitive overload and fatigue severity. Assumptions were tested before analysis. Fatigue severity and cognitive load were measured using the Checklist Individual Strength, subscale Fatigue Severity and subscale Concentration. Linear regression analysis was performed. Additionally, a post-hoc sensitivity analysis was performed among participants with visual impairment in both eyes (N=152, 59% female, mean age of 57±15). Factors confounding or moderating this association were included and tested for both analyses (p-values of ≤ 0.05). R-Squared (R²) was determined to assess the performance of the final model.

Results : The association between fatigue severity and cognitive overload was significantly present in the main analysis (β: 0.486; 95% CI: 0.294-0.678; p= <0.001), as well as in the post-hoc sensitivity analysis (β: 0.422; 95% CI: 0.194-0.650; p= <0.001). No confounders or effect modifiers were found in either analysis. The R² of the main model was 0.106 (p= <0.001) and 0.082 (p= <0.001) for the post-hoc sensitivity analysis, indicating a respectable variance of fatigue was explained by the variance of cognitive overload in this regression model.

Conclusions : Cognitive overload is strongly associated with fatigue severity in adults with visual impairment. The knowledge of the presence and correlation of both factors in people with visual impairment is valuable for both patients and healthcare workers to explore potential treatment options.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.