Aging With Vision Loss: A Framework for Assessing the Impact of Visual Impairment on Older Adults

Swenor, Bonnielin K.; Lee, Moon J.; Varadaraj, Varshini; Whitson, Heather E.; Ramulu, Pradeep Y.

doi:10.1093/geront/gnz117

Cited by 89 publications

(69 citation statements)

References 65 publications

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“…VI in older adults is attributable to refractive error (correctable with glasses) and eye disease (often not correctable or requiring surgical/medical interventions: age-related macular degeneration, ocular complications of diabetes mellitus, glaucoma, and age-related cataracts) [ 3 , 4 ]. According to Swenor et al [ 3 ], in the United States, uncorrected refractive error accounts for approximately 79% of VI, and cataracts are the most common correctable eye disease, accounting for approximately 50% of VI from eye disease. There are also effective strategies to prevent or delay late-life vision loss and blindness resulting from other defined diseases [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Internet and Health Information Technology Use and Psychological Distress Among Older Adults With Self-Reported Vision Impairment: Case-Control Study

Choi¹,

DiNitto²,

Lee³

et al. 2020

J Med Internet Res

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Background The number of older adults with vision impairment (VI) is growing. As health care services increasingly call for patients to use technology, it is important to examine internet/health information technology (HIT) use among older adults with VI. Objective This study aimed to examine (1) the rates of internet/HIT use among older adults with VI compared with a matched sample of their peers without VI, (2) associations of VI with internet/HIT use, and (3) association of HIT use with psychological distress, assessed with the Kessler-6 screen. Methods Data were obtained from the 2013 to 2018 US National Health Interview Survey. Older adults (aged ≥65 years) with self-reported VI were matched with older adults without VI, in a 1:1 ratio, based on age, sex, number of chronic medical conditions, and functional limitations (N=2866). Descriptive statistics and multivariable logistic regression models, with sociodemographic factors, health conditions, health insurance type, and health care service use as covariates, were used to examine the research questions. Results In total, 3.28% of older adults (compared with 0.84% of those aged 18-64 years) reported VI, and 25.7% of them were aged ≥85 years. Those with VI were significantly more socioeconomically disadvantaged than those without VI and less likely to use the internet (adjusted odds ratio [aOR] 0.64, 95% CI0.49-0.83) and HIT (aOR 0.74, 95% CI 0.56-0.97). However, among internet users, VI was not associated with HIT use. HIT use was associated with lower odds of mild/moderate or serious psychological distress (aOR 0.62, 95% CI 0.43-0.90), whereas VI was associated with greater odds of mild/moderate or serious distress (aOR 1.84, 95% CI 1.36-2.49). Health care provider contacts were also associated with higher odds of internet or HIT use. Conclusions Compared with their matched age peers without VI, older adults with VI are less likely to use HIT because they are less likely to use the internet. Socioeconomically disadvantaged older adults experiencing a digital divide need help to access information and communication technologies through a fee waiver or subsidy to cover internet equipment and subscription and ensure continuous connectivity. Older adults with VI who do not know how to use the internet/HIT but want to learn should be provided instruction, with special attention to accessibility features and adaptive devices. Older adults with a low income also need better access to preventive eye care and treatment of VI as well as other health care services.

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Section: Introductionmentioning

confidence: 99%

Internet and Health Information Technology Use and Psychological Distress Among Older Adults With Self-Reported Vision Impairment: Case-Control Study

Choi¹,

DiNitto²,

Lee³

et al. 2020

J Med Internet Res

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show abstract

“…Our findings thus imply that the assumption that “successful aging may be more challenging for visually impaired older adults” (Swenor, Lee, et al, 2019) needs refinement: Whether an older age represents an additional challenge to successful aging among individuals with vision loss depends on various factors, including the specific outcome domains as well as the time frame and dynamics of vision loss.…”

Section: Discussionmentioning

confidence: 87%

“…The consequences of visual impairments affect different developmental domains (Heyl & Wahl, 2014; Swenor, Lee, et al, 2019; Wahl, 2013; Zimdars et al, 2012). Regarding health and cognitive ability , individuals with impaired vision reveal a steeper functional health decline compared to individuals with intact vision (Lin et al, 2004), and this decline results in increasing difficulties with everyday tasks such as stair climbing or use of public transportation.…”

Section: Consequences Of Impaired Visionmentioning

confidence: 99%

Associations of self-reported vision problems with health and psychosocial functioning: A 9-year longitudinal perspective

Wettstein¹,

Spuling

Hans-Werner-Wahl

et al. 2020

British Journal of Visual Impairment

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Impaired vision often results in restrictions across diverse key indicators of successful aging. However, little is known about how impaired vision affects the long-term trajectories of these outcomes, whether effects are moderated by age, and whether psychosocial resources beyond well-being such as subjective age views are also affected by vision loss. We analyzed how self-reported vision problems as a time-varying predictor are related to long-term changes in health and cognitive ability (functional health, number of chronic diseases, self-rated health, information processing speed), well-being (life satisfaction, positive and negative affect, depressive symptoms, loneliness), and subjective age views (subjective age; aging-related cognitions: social loss, physical decline, continuous growth). Our sample was derived from the German Ageing Survey, comprising 6,378 individuals (40–89 years) who provided up to four observations over a 9-year period. Controlling for gender, age, education, and functional as well as self-rated health, we observed that both on a between- and a within-person level, indicators of successful aging were consistently less favorable among individuals with more vision problems. Associations between vision problems and functional health became stronger with advancing age. In contrast, with increasing age, vision problems were less closely associated with change in several indicators of psychosocial functioning. Our findings suggest that self-reported visual impairment is associated with restrictions across a broad range of developmental domains. Some detrimental effects of vision problems are augmented in later life, whereas several effects on well-being and subjective age views were attenuated with advancing age, which might indicate processes of late-life adaptation to vision loss.

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“…Increasing numbers of adults worldwide are experiencing progressive and permanent loss of vision [ 1 , 2 ]. Many visual impairments are a result of retinal degeneration from inherited and age-related diseases, as well as from chronic health conditions such as cardiovascular disease and diabetes [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

VEGF Upregulates EGFR Expression to Stimulate Chemotactic Behaviors in the rMC-1 Model of Müller Glia

Peña

Vázquez

2020

Brain Sciences

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Progressive vision loss in adults has become increasingly prevalent worldwide due to retinopathies associated with aging, genetics, and epigenetic factors that damage the retinal microvasculature. Insufficient supply of oxygen and/or nutrients upregulates factors such as vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF), which can induce abnormal angiogenesis and damage the structural arrangement of the retinal blood barrier (BRB). Müller glia (MG) regulate the diffusion of essential compounds across the BRB and respond to retinal insults via reactive gliosis, which includes cell hypertrophy, migration, and/or proliferation near areas of elevated VEGF concentration. Increasing concentrations of exogenous VEGF, upregulated by retinal pigmented epithelium cells, and endogenous epidermal growth factor receptor (EGF-R) stimulation in MG, implicated in MG proliferative and migratory behavior, often lead to progressive and permanent vision loss. Our project examined the chemotactic responses of the rMC-1 cell line, a mammalian MG model, toward VEGF and EGF signaling fields in transwell assays, and within respective concentration gradient fields produced in the glia line (gLL) microfluidic system previously described by our group. rMC-1 receptor expression in defined ligand fields was also evaluated using quantitative polymerase chain reaction (qPCR) and immunocytochemical staining. Results illustrate dramatic increases in rMC-1 chemotactic responses towards EGF gradient fields after pre-treatment with VEGF. In addition, qPCR illustrated significant upregulation of EGF-R upon VEGF pre-treatment, which was higher than that induced by its cognate ligand, EGF. These results suggest interplay of molecular pathways between VEGF and EGF-R that have remained understudied in MG but are significant to the development of effective anti-VEGF treatments needed for a variety of retinopathies.

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Aging With Vision Loss: A Framework for Assessing the Impact of Visual Impairment on Older Adults

Cited by 89 publications

References 65 publications

Internet and Health Information Technology Use and Psychological Distress Among Older Adults With Self-Reported Vision Impairment: Case-Control Study

Internet and Health Information Technology Use and Psychological Distress Among Older Adults With Self-Reported Vision Impairment: Case-Control Study

Associations of self-reported vision problems with health and psychosocial functioning: A 9-year longitudinal perspective

VEGF Upregulates EGFR Expression to Stimulate Chemotactic Behaviors in the rMC-1 Model of Müller Glia

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