Abstract
Purpose :
To determine the degree to which functional metrics and self-reported quality of life agree in glaucoma, and identify factors associated with discrepancies between the two.
Methods :
Participants with glaucoma or suspected glaucoma (n=227) were evaluated. Subjective functioning was assessed with the Glaucoma Quality of Life-15 (GQL-15) questionnaire. Objective metrics of functioning included balance (total sway), gait (cadence), and reading speed, which were compiled into a z-scored composite measure of functioning. Discrepancy scores were defined as the difference between composite functioning and GQL-15 z-scores, with positive discrepancy scores indicating higher functioning relative to self-reported quality of life. Linear regression models were computed to identify factors associated with discrepancy between objective functional metrics and self-reported quality of life, including visual field sensitivity, depressive symptoms, MMSE scores, race, ethnicity, age, marital status, education, gender, employment status, median household income, living arrangement, and neighborhood metrics of crime rates, ADI percentile, and poverty.
Results :
Among participants, 48.9% were female, 26.9% identified as Black, and mean age was 70.4±7.5 years. Composite functioning and GQL-15 z-scores were poorly correlated (Pearson’s coefficient r=0.15, p-value=0.024). In multivariable analysis, positive discrepancy (greater objective functioning than self-report) was associated with female gender (β= +0.53 vs. males, p<0.001), depressive symptoms (β=+0.19, p<0.001), and greater visual field damage (β=+0.28, p-value=0.001). A multivariable model including gender, depressive symptoms, and visual field sensitivity accounted for 20% of the variance in discrepancy scores. Social and demographic factors, including race, ethnicity, household income, age, MMSE scores, marital status, living arrangement, employment status, education, and neighborhood metrics of crime, ADI percentile, and poverty showed no significant association with discrepancy scores.
Conclusions :
Female gender, depressive symptoms, and greater visual field damage predict more subjective vision-related disability as compared to objective functional impairment. However, the overall ability of the studied measures to predict discrepancy between function and self-report was poor, highlighting the complexity of relationship between self-reported impairment and functional evaluation.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.