Impact of age related macular degeneration on quality of life

Abstract

Aims: To describe the impact of age related macular degeneration (AMD) on quality of life and explore the association with vision, health, and demographic variables. Methods: Adult participants diagnosed with AMD and with impaired vision (visual acuity ,6/12) were assessed with the Impact of Vision Impairment (IVI) questionnaire. Participants rated the extent that vision restricted participation in activities affecting quality of life and completed the Short Form General Health Survey (SF-12) and a sociodemographic questionnaire. Results: The mean age of the 106 participants (66% female) was 83.6 years (range 64-98). One quarter had mild vision impairment, (VA,6/12-6/18) and 75% had moderate or severely impaired vision. Participants reported from at least ''a little'' concern on 23 of the 32 IVI items including reading, emotional health, mobility, and participation in relevant activities. Those with mild and moderate vision impairment were similarly affected but significantly different from those with severe vision loss (p,0.05). Distance vision was associated with IVI scores but not age, sex, or duration of vision loss. Conclusion: AMD affects many quality of life related activities and not just those related to reading. Referral to low vision care services should be considered for people with mild vision loss and worse.A ge related macular degeneration (AMD) is a leading cause of vision impairment in the developed world.1 Success of treatment is often defined in terms of preservation of remaining vision rather than improvement in vision.2 There are few known risk factors and evidence for the prevention of AMD remains intangible.3 While intensive research continues into new treatments, potential new environmental and genetic risk factors, and predictive and preventative measures, 2 3 there has been less focus on the impact of vision impairment on people with AMD. Clinicians and the community in general undervalue or are not well aware of the broad impact of AMD on health related quality of life. 4 We know vision loss is associated with increased morbidity, including an increased risk of falls. 5 6 Recent research has shown how vision impairment compromises quality of life and limits social interaction and independence.6 7 Vision impairment caused by AMD has also been shown to interfere with the person's ability to care for themselves and others indicating need for community and vision related support. 8Vision loss from AMD has been shown to be associated with depression and that significant psychological distress is similar to that of people with other serious chronic illness. 9 10 Therefore, the current lack of effective preventive measures and treatment for most people with AMD emphasises the importance of timely referral and vision rehabilitation, yet only a small proportion of people with impaired vision access low vision rehabilitation services. [11][12][13] Consequently, the aim of this paper was to describe the impact of vision loss from AMD on a broad range of daily life activities and to determine the ...

Study of psycho-social impairment in patients presenting with age related macular degeneration in a tertiary eye care hospital

“…8 In a similar study Hassel JB et al it is also stated that on assessing psycho-social impact of ARMD through Impairment of Vision Questionnaire, it was found that patients of ARMD have impairment related to not only reading but also of emotional health, mobility, and participation in relevant activities and their referral to low vision care services is necessary. 9 This all studies showed similar results of impairment as found in our study.…”

Participation of the elderly after vision loss

“…From age 75, participation decreases strongly [10]. In addition to the effect of aging, vision loss may not only lead to difficulties in performing activities [11][12][13][14][15][16][17] but also to loss of activities [18,19], dependency [20][21][22] and social isolation [23]. Vision loss is related to depression [24][25][26][27] and emotional distress [28] and has a negative impact on health-related quality of life [15,[28][29][30][31][32][33].…”

Caregiver perceptions about the impact of caring for patients with wet age-related macular degeneration

“…3,[6][7][8] The personality traits of a caregiver, as evidenced by this study, include compassion; self-sacrifice; ability to accept additional responsibility; and provide a positive and encouraging environment. This requires a significant degree of commitment by the caregiver and historically, developing a 'compassionate character', for example, in Florence Nightingale's view, specifically underpinned quality of nursing care.…”

“…The resultant burden of this disease is well established. [6][7][8][9] Caregivers of older persons with AMD have higher than expected distress, particularly if the person has 'wet' AMD. 3,5 The principal cause of vision loss in wet AMD is choroidal neovascularisation.…”

“…AMD affects central vision and impacts fine detailed visual tasks such as reading, daily living activities and driving and so on. [6][7][8] The prevalence of AMD across the developed world is markedly increasing owing to the ageing population. The resultant burden of this disease is well established.…”