Age-related macular degeneration (AMD) is the leading cause of visual impairment in older adults in the United Kingdom. This study sought to characterise AMD patients who seek the services of the Macular Society, and determine the level and source of their dietary knowledge. A questionnaire was designed, validated, and administered to 158 participants. The questions covered demographic data and knowledge of nutrition and supplementation. The mean age of participants was 79 years; 61% of them were female, and 27% were registered visually impaired. Only 55% of the participants thought diet was important for eye health, 63% felt that they had not received enough information about AMD. The participants reported that their information mainly came from non-professional support groups. Most participants identified healthy food, but could not say why, and were not able to identify carotenoid rich foods. The results of the study will inform design of education and dissemination methods regarding dietary information.
For an 'informed' population, many AMD participants were under-consuming nutrients considered to be useful for their condition. Participants without AMD were more likely to reach recommended daily allowance values for energy and a range of nutrients. It is therefore essential to design more effective dietary education and dissemination methods for people with, and at risk of, AMD.
Research has shown that individuals affected by age-related macular degeneration (AMD) do not always consume foods or supplements known to be beneficial for ocular health. This study tested the effectiveness of an educational intervention designed to promote healthy eating and nutritional supplementation in this group. A total of 100 individuals with AMD completed baseline measures of several variables: confidence that diet affects AMD, motivation to engage in health-protective behaviours, knowledge about which nutrients are beneficial, and intake of kale, spinach, and eggs. Participants were allocated to either intervention or control conditions. Intervention participants received a leaflet and prompt card that contained advice regarding dietary modification and supplementation. Control participants received a leaflet created by the Royal College of Optometrists. A follow-up questionnaire, measuring the same variables assessed at baseline, was administered 2 weeks later. At follow-up, significant condition × time interactions were found for confidence that diet affects AMD (F(1, 92) = 4.54, p < .05), motivation to talk to an eye professional about supplementation (F(1, 92) = 4.53, p = .036), motivation to eat eggs (F(1, 92) = 12.67, p = .001), and egg intake (F(1, 92) = 11.97, p = .001). In each case, intervention participants scored higher than control participants. Receiving an educational intervention increased participants' confidence that diet affects AMD, motivation to engage in health-protective behaviours, and egg intake. This intervention could be easily incorporated into current clinical practice delivered by either optometrists or ophthalmologists.
Age-related macular disease (AMD) is a multifactorial degenerative condition affecting the central area of the retina. Patients with AMD report that eye care practitioners are not giving consistent advice regarding nutrition and reported confusion as to what advice, if any, to follow. The aim of this study was to design and conduct a preliminary evaluation of a flowchart to support eye care practitioners in providing accurate, evidence-based nutritional advice to their patients. A flowchart was designed to take practitioners through a decision-making process that would determine whether a patient matched the Age-Related Eye Disease Study (AREDS) 2 eligibility criteria for supplementation. The flowchart was evaluated using a qualified and student optometrist cohort, with both cohorts completing confidence scales and students completing clinical scenarios. Qualified participants showed a significant increase in confidence scores from the initial survey (M = 69.7%, standard deviation [SD] = 16.2%) to the second survey after use of the flowchart for 2 weeks (M = 82.1%, SD = 11.6%; t(45) = 7.33, p < .001; rs = .61, p < .001). The student participants also increased confidence scored after receiving the flowchart (M of first survey = 41.7, SD = 14.6; M of second survey = 69.1, SD = 1.7; t(25) = 7.92, d = .81, p < .001) and increased the number of correct answers on five clinical scenarios. Overall, the flowchart has proved to be useful in boosting the self-efficacy of both qualified practitioners and student practitioners, as well as improving clinical decisions made by student practitioners.
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