Visual Impairment, Undercorrected Refractive Errors, and Activity Limitations in Older Adults: Findings From the Three-City Alienor Study

Naël, Virginie; Pérès, Karine; Carrière, Isabelle; Daïen, Vincent; Scherlen, Anne-Catherine; Arleo, Angelo; Korobelnik, Jean‐François; Delcourt, Cécile; Helmer, Catherine

doi:10.1167/iovs.17-21525

Cited by 21 publications

(19 citation statements)

References 36 publications

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“…Many prior studies have taken a less nuanced approach to understanding the adverse consequences of VI. For example, among the numerous studies that have reported increased activity limitations in older adults with VI (11,33,34), few have accounted for whether respondents successfully accommodate for declines in functioning, perform activities less frequently, or perform an activity only with considerable difficulty. In the current study, the activity limitation hierarchies were a significant mediator of the relationship between VI and SWB, which suggests that interventions to promote successful accommodation could move individuals higher on these hierarchies, which may improve SWB.…”

Section: Discussionmentioning

confidence: 99%

Self-reported Vision Impairment and Subjective Well-being in Older Adults: A Longitudinal Mediation Analysis

Xiang

Freedman

Shah

et al. 2019

The Journals of Gerontology: Series A

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Abstract Background Vision impairment (VI) in older adults is associated with declines in well-being. However, the pathways through which poor vision leads to declines in well-being have not been well-described. The purpose of this study was to determine whether activity limitations and social participation restrictions mediate the impact of self-reported VI on subjective well-being. Methods The National Health and Aging Trends Study (NHATS) is a nationally representative longitudinal study of Medicare beneficiaries 65 and older that includes detailed measures of the disablement process. A longitudinal mediation model was conceptualized linking self-reported VI and subjective well-being. Structural equation modeling was used to test the mediating effects of activity limitations and social participation restrictions while adjusting for relevant covariates. Results The final sample included 5,431 respondents. At baseline, 8.0% of Medicare beneficiaries had self-reported VI. Subjective well-being scores were significantly lower among respondents with self-reported VI (15.7; 95% confidence interval [CI]: 15.2, 16.2) compared with those without VI (17.6; 95% CI: 17.5, 17.7). Self-reported VI had a significant indirect effect on subjective well-being through limiting mobility (β = −0.04; 95% CI: −0.07, −0.03) and household activities (β = −0.05; 95% CI: −0.08, −0.03), but not self-care limitations (β = 0.0; 95% CI = 0.0, 0.0) or participation restrictions (β = 0.0; 95% CI = −0.01, 0.00). Total indirect effects from all mediation paths accounted for 42% of the effect of VI on well-being. Conclusions Mobility and household activity limitations are significant mediators that explain a considerable portion of the impact of poor vision on well-being. Interventions to promote successful accommodation may result in greater overall well-being for older adults with poor vision.

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Section: Discussionmentioning

confidence: 99%

Self-reported Vision Impairment and Subjective Well-being in Older Adults: A Longitudinal Mediation Analysis

Xiang

Freedman

Shah

et al. 2019

The Journals of Gerontology: Series A

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“…Nowadays, there are treatment options for the majority of these diseases, nevertheless there is still a sizeable number of subjects with moderate and severe VI (presenting visual acuity <6/18, but ≥3/60 in the better eye), namely, 1.0% in high-income countries (Central Europe, Western Europe, North America, Australasia, Pacific Asia) in 2010 (point prevalence) ( 4 ). Decreased vision does not only reduce mobility but also limits activity of daily life and restricts social participation ( 5 ); similar impairments are also seen in subjects with depression.…”

Section: Introductionmentioning

confidence: 98%

Visual Impairment Is Associated With Depressive Symptoms—Results From the Nationwide German DEGS1 Study

et al. 2018

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IntroductionVisual impairment (VI) is associated with a variety of comorbidities including physical and mental health in industrial countries. Our aim is to examine associations between self-reported impairment and depressive symptoms in the German population.MethodsThe point prevalence of self-reported VI in Germany was computed using data from the German Health Interview and Examination Survey for adults from 2008 to 2011 (N = 7.783, 50.5% female, age range 18–79 years). VI was surveyed by two questions, one for seeing faces at a distance of 4 m and one for reading newspapers. Depressive symptoms were evaluated with the Patient Health Questionnaire-9 questionnaire and 2-week prevalence was computed with weighted data. Depressive symptoms were defined by a value of ≥10. Logistic regression analysis was performed to analyze an association between self-reported VI and depressive symptoms. Multivariable analysis including adjustment for age, gender, socioeconomic status, and chronic diseases were carried out with weighted data.ResultsThe 2-week prevalence of depressive symptoms was 20.8% (95% CI: 16.6–25.7%) for some difficulties in distance vision and 14.4% (95% CI: 7.5–25.9%) for severe difficulties in distance vision, while 17.0% (95% CI: 13.3–21.4%), respectively, 16.7% (95% CI: 10.7–25.1%) for near vision. Analysis revealed that depressive symptoms were associated with self-reported VI for reading, respectively, with low VI for distance vision. Multivariable regression analysis including potential confounders confirmed these findings.ConclusionDepressive symptoms are a frequent finding in subjects with difficulties in distance and near vision with a prevalence of up to 24%. Depressive comorbidity should therefore be evaluated in subjects reporting VI.

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“…According to a study by Nael et al [21] Myopia is a very common ophthalmologic disease, and its prevalence is increasing worldwide. Considering educational activities, continuous urbanization, and westernization, it is estimated that the prevalence of myopia will continue to increase [27] [28].…”

Section: Discussionmentioning

confidence: 99%

Clinical differences between toric intraocular lens (IOL) and monofocal intraocular lens (IOL) implantation when myopia is determined as target refraction

Shin

Hwang

Kim

et al. 2020

Preprint

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Background: The aim of this study is to analyze and compare the clinical results of toric intraocular lens (IOL) and monofocal IOL implantation when the target refraction value is determined -3 diopter (D) in cataract patients with corneal astigmatism >1.5 diopters (D).Methods: We performed a retrospective chart review for patients with corneal astigmatism >1.5D who underwent cataract surgery and their target refraction is determined -3D. 100 eyes (100 patients; monofocal IOL, 60; toric IOL, 40) were enrolled in the current study. Near and distant uncorrected visual acuity (UCVA), corrected VA, spherical equivalent and refractive, corneal astigmatism were evaluated before and after surgery.Results: The near UCVA of the toric IOL group (0.26±0.33) after cataract surgery was significantly better than that of the monofocal IOL group (0.48±0.32) (p=0.030). The distant UCVA of the toric IOL group (0.38 ± 0.14) was also significantly better than that of the monofocal IOL group (0.55 ± 0.22) (p = 0.026). There were no significant intergroup differences in postoperative best-corrected visual acuity (p = 0.710) and mean spherical equivalent (p = 0.465). In the toric IOL group, postoperative refractive astigmatism was -0.80 ± 0.46D and postoperative corneal astigmatism was -1.50 ± 0.62D, whereas the corresponding values in the monofocal IOL group were -1.65 ± 0.77D and -1.45 ± 0.64D; residual refractive astigmatism was significantly lower with toric IOL implantation compared with monofocal IOL implantation (p = 0.001). There were no postoperative complications and no adverse events were reported.Conclusions: When myopic refraction such as -3D was determined as the target power in patients with corneal astigmatism, toric IOL implantation led to excellent improvement in both near and distant UCVA.

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Visual Impairment, Undercorrected Refractive Errors, and Activity Limitations in Older Adults: Findings From the Three-City Alienor Study

Abstract: About one-sixth of IADL limitations and one-fifth of social participation restrictions could be prevented by an optimal optical correction. These results underline the importance of eye examinations in older adults to prevent disability.

Cited by 21 publications

References 36 publications

Self-reported Vision Impairment and Subjective Well-being in Older Adults: A Longitudinal Mediation Analysis

Self-reported Vision Impairment and Subjective Well-being in Older Adults: A Longitudinal Mediation Analysis

Visual Impairment Is Associated With Depressive Symptoms—Results From the Nationwide German DEGS1 Study

Clinical differences between toric intraocular lens (IOL) and monofocal intraocular lens (IOL) implantation when myopia is determined as target refraction

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