Estimation of Loss of Visual Efficiency

Spaeth, Edmund B.; Fralick, F. Bruce; Hughes, William F.; Scheie, Harold G.

doi:10.1001/archopht.1955.00930020468021

Cited by 63 publications

(29 citation statements)

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“…Severe hearing impairment was defined as 4 out of 4 tones missed, based on 1,000-and 2,000-Hz measurements for the left and right ears, using a handheld AudioScope (25). Percent vision impairment was assessed with a Jaeger card, with the participant wearing their own reading glasses when applicable (26). Functional self-efficacy, a measure of confidence in performing various activities, was assessed with the Modified Self-Efficacy Scale (17,27).…”

Section: Data Collectionmentioning

confidence: 99%

Factors Associated with Functional Recovery among Older Intensive Care Unit Survivors

Ferrante

Pisani

Murphy

et al. 2016

Am J Respir Crit Care Med

124

114

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Rationale: Most of the 1.4 million older adults who survive the intensive care unit (ICU) annually in the United States face increased disability, but little is known about those who achieve functional recovery.Objectives: Our objectives were twofold: to evaluate the incidence and time to recovery of premorbid function within 6 months of a critical illness and to identify independent predictors of functional recovery among older ICU survivors.Methods: Potential participants included 754 persons aged 70 years or older who were evaluated monthly in 13 functional activities (1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012). The analytic sample included 218 ICU admissions from 186 ICU survivors. Functional recovery was defined as returning to a disability count less than or equal to the pre-ICU disability count within 6 months. Twenty-one potential predictors were evaluated for their associations with recovery.Measurements and Main Results: Functional recovery was observed for 114 (52.3%) of the 218 admissions. In multivariable analysis, higher body mass index (hazard ratio [HR], 1.07; 95% confidence interval [CI], 1.03-1.12) and greater functional selfefficacy (HR, 1.05; 95% CI, 1.02-1.08), a measure of confidence in performing various activities, were associated with recovery, whereas pre-ICU impairment in hearing (HR, 0.38; 95% CI, 0.22-0.66) and vision (HR, 0.59; 95% CI, 0.37-0.95) were associated with a lack of recovery.Conclusions: Among older adults who survived an ICU admission with increased disability, pre-ICU hearing and vision impairment were strongly associated with poor functional recovery within 6 months, whereas higher body mass index and functional selfefficacy were associated with recovery. Future research is needed to evaluate whether interventions targeting these factors improve functional outcomes among older ICU survivors. The organizations funding this study had no role in the design or conduct of the study; in the collection, management, analysis, or interpretation of the data; or in the preparation, review, or approval of the manuscript.Author Contributions: Study concept and design: L.E.F. and T.M.G.; acquisition, analysis, or interpretation of data: all authors; drafting of the manuscript: L.E.F., T.E.M., and E.A.G.; critical revision of the manuscript for important intellectual content: L.E.F., T.M.G., M.A.P., and T.E.M.; statistical analysis: T.E.M. and E

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Section: Data Collectionmentioning

confidence: 99%

Factors Associated with Functional Recovery among Older Intensive Care Unit Survivors

Ferrante

Pisani

Murphy

et al. 2016

Am J Respir Crit Care Med

124

114

View full text Add to dashboard Cite

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“…18 Sensory information included hearing, assessed by the Whisper test, 23 and corrected near visual acuity, assessed with the Rosenbaum card and calculated as the percentage of visual impairment. 24 Functional information included mobility, determined from the number of blocks walked and the flights of stairs climbed on an average day; and cognitive status, assessed with the Folstein Mini-Mental State Examination (MMSE). 25 Physical performance skills were assessed by three timed tests: walking back and forth over a 10-foot course, turning in a full circle, and standing up and sitting down from a hardback chair three times with arms folded.…”

Section: Candidate Predictorsmentioning

confidence: 99%

Predictors of recovery in activities of daily living among disabled older persons living in the community

1997

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OBJECTIVE:To identify the factors that predict recovery in activities of daily living (ADLs) among disabled older persons living in the community. DESIGN:Prospective cohort study with 2-year follow-up. SETTING: General community.PARTICIPANTS: 213 men and women 72 years or older, who reported dependence in one or more ADLs. MEASUREMENTS AND MAIN RESULTS:All participants underwent a comprehensive home assessment and were followed for recovery of ADL function, defined as requiring no personal assistance in any of the ADLs within 2 years. Fifty-nine participants (28%) recovered independent ADL function. Compared with those older than 85 years, participants aged 85 years or younger were more than 8 times as likely to recover their ADL function (relative risk [RR] 8.4; 95% confidence interval [CI] 2.7, 26). Several factors besides age were associated with ADL recovery in bivariate analysis, including disability in only one ADL, self-efficacy score greater than 75, Folstein Mini-Mental State Examination (MMSE) score of 28 or better, high mobility, score in the best third of timed physical performance, fewer than five medications, and good nutritional status. In multivariable analysis, four factors were independently associated with ADL recovery-age 85 years or younger (adjusted RR 4.1; 95% CI 1.3, 13), MMSE score of 28 or better (RR 1.7; 95% CI 1.2, 2.3), high mobility (RR 1.7; 95% CI 1.0, 2.9), and good nutritional status (RR 1.6; 95% CI 1.0, 2.5). A mong community-living older persons, the prevalence of disability in one or more activities of daily living (ADLs), such as bathing, dressing, and walking, increases substantially with age, from about 7% in those aged 65 to 74 years, to 14% in those aged 75 to 84 years, to over 24% in those aged 85 years or older. 1 Although useful in estimating the need for health care resources, prevalence estimates of disability do not convey that functional status and disability represent dynamic processes in older persons. Belying the stereotype of the older person as having an inexorable downhill course, from mild impairment to disability, longitudinal studies have found that a substantial minority (24%-30%) of elders, once disabled, recover independence in their ADL function. 1,2 Why some disabled elders recover and others do not is not known. Those who recover can be considered to be resilient. 3 If carefully studied and suitably characterized, these resilient elders might offer investigators valuable insights into the mechanisms of disability and dependence in older persons and facilitate the development of effective and efficient intervention programs to prevent, slow, or reverse ADL dependence. 4 Previous studies of functional recovery have focused almost exclusively on persons hospitalized after an acute event, such as a stroke or hip fracture. [5][6][7][8][9] Conversely, several community-based studies have sought to elucidate the determinants of ADL dependence, 10-12 but none has tried to identify the factors, besides age, that predict recovery of ADL function. CONCLUSIONS:T...

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“…The test-retest reliability of the Whisper Test and audioscope are 0.78 (intraclass correlation) and 0.74 (kappa), respectively (Lichtenstein et al, 1988;Ulhmann, Rees, Psaty, & Duckert, 1989). The sensitivity of both tests against full audiograms is 94% (Lichtenstein et al 1988;Spaeth et al, 1955). The correlation between Whisper Test and audioscope results was not assessed.…”

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confidence: 99%