Is Vision Function Related to Physical Functional Ability in Older Adults?

West, Catherine G.; Gildengorin, Ginny; Hægerström-Portnoy, Gunilla; Schneck, Marilyn E.; Lott, Lori A.; Brabyn, John A.

doi:10.1046/j.1532-5415.2002.50019.x

Cited by 122 publications

(102 citation statements)

References 23 publications

(52 reference statements)

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“…Many of these objectively measurable visual functions have found to associate with balance and mobility performance. In community-settings loss in contrast sensitivity RW.ERRORRW.ERROR (Lord and Menz 2000;Tiedemann et al 2005;West et al 2002a;West et al 2002b), stereopsis (Lord and Menz 2000), visual fields (West et al 2002a;Patel et al 2006) as well as visual acuity (West et al 2002b) have been associated with impaired postural control or mobility. However, less is known about interactions between these different types of vision impairment (Dhital et al 2010).…”

Section: Introductionmentioning

confidence: 99%

Relationship between functional vision and balance and mobility performance in community-dwelling older adults

et al. 2013

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Section: Introductionmentioning

confidence: 99%

Relationship between functional vision and balance and mobility performance in community-dwelling older adults

et al. 2013

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“…glaucoma, retinis pigmentosa) or attentional (e.g. reduction in 'useful field of view') impairments (Owsley et al 1995;Geruschat et al 1998;Sekuler et al 2000;West et al 2002;Turano et al 2004;Cedrone et al 2008). Conversely, reliance on peripheral vision may be the only option for people with macular degeneration.…”

Section: Discussionmentioning

confidence: 99%

The use of peripheral vision to guide perturbation-evoked reach-to-grasp balance-recovery reactions

et al. 2010

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For a reach-to-grasp reaction to prevent a fall, it must be executed very rapidly, but with sufficient accuracy to achieve a functional grip. Recent findings suggest that the CNS may avoid potential time delays associated with saccade-guided arm movements by instead relying on peripheral vision (PV). However, studies of volitional arm movements have shown that reaching is slower and/or less accurate when guided by PV, rather than central vision (CV). The present study investigated how the CNS resolves speed-accuracy trade-offs when forced to use PV to guide perturbation-evoked reach-to-grasp balance-recovery reactions. These reactions were evoked, in 12 healthy young adults, via sudden unpredictable anteroposterior platform translation (barriers deterred stepping reactions). In PV trials, subjects were required to look straight-ahead at a visual target while a small cylindrical handhold (length 25%> hand-width) moved intermittently and unpredictably along a transverse axis before stopping at a visual angle of 20°, 30°, or 40°. The perturbation was then delivered after a random delay. In CV trials, subjects fixated on the handhold throughout the trial. A concurrent visuo-cognitive task was performed in 50% of PV trials but had little impact on reach-to-grasp timing or accuracy. Forced reliance on PV did not significantly affect response initiation times, but did lead to longer movement times, longer timeafter-peak-velocity and less direct trajectories (compared to CV trials) at the larger visual angles. Despite these effects, forced reliance on PV did not compromise ability to achieve a functional grasp and recover equilibrium, for the moderately large perturbations and healthy young adults tested in this initial study.

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“…[15][16][17] West et al 18 reported that if more sophisticated tests of visual function such as contrast sensitivity, glare recovery, and dark acuity tests were used, then up to 60% of elderly subjects assessed with these tests failed them, compared to only 20% of the same cohort who failed standard high-contrast (Snellen) visual acuity tests. Similarly, it is now well recognised that standard clinical tests of a patient's visual field may also underestimate the peripheral visual field problems in this group of patients.…”

Section: Eyementioning

confidence: 99%

“…20,21 Furthermore, visual impairment impacts on a wide range of objective and subjective measures of functional status, including those measures which are not actually vision dependant, such as psychological well being. 16,18,[22][23][24][25] One of the principle aims of the current study was to develop a simple bedside screening test that could be incorporated into the rehabilitation package offered to patients who fall sustaining a fractured neck of femur. While not without its limitations, high-contrast Snellen visual acuity is still deemed to be a useful indicator of the ability of an older patient to perform a range of visiondependant daily living tasks.…”

Section: Eyementioning

confidence: 99%

Screening for visual impairment in elderly patients with hip fracture: validating a simple bedside test

Squirrell

Kenny

Mawer

et al. 2004

Eye

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Aims 1. To assess the prevalence of visual impairment in those patients who sustain proximal hip fracture after a simple fall. 2. To test the validity of a simple screening test to identify patients with visual impairment. Methods Patients on the orthopaedic rehabilitation ward recuperating from proximal hip fracture were recruited. The nurse screener and examining Ophthalmologist independently assessed the patients' distance visual acuity and visual field to confrontation. In addition, the nurse screener assessed for the presence of cataract in the red reflex and the examining Ophthalmologist performed a dilated slitlamp examination. On completion of the examination, the Ophthalmologist documented the cause(s) of any visual impairment found. Results A total of 89 patients were assessed. In all, 29 patients (33%) could be classified as visually impaired using the United States criteria and 52 patients (58%) had a distance visual acuity of 6/18 or worse in at least one eye. The test reliably identified those patients with visual impairment (sensitivity 94%(75%), specificity 92%(76%)), but was less reliable at identifying those patients with potentially remedial visual impairment (sensitivity 70%(710%), specificity 92%(76%)). Conclusion The level of visual impairment in this group of patients is high and screening for visual impairment in the elderly with a history of falls is justified. We have demonstrated that a suitably trained member of the rehabilitation team can identify over 94% of those patients with impaired vision. We believe this simple test should now be incorporated into the assessment of all patients requiring rehabilitation after a proximal hip fracture.

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Is Vision Function Related to Physical Functional Ability in Older Adults?

Cited by 122 publications

References 23 publications

Relationship between functional vision and balance and mobility performance in community-dwelling older adults

Relationship between functional vision and balance and mobility performance in community-dwelling older adults

The use of peripheral vision to guide perturbation-evoked reach-to-grasp balance-recovery reactions

Screening for visual impairment in elderly patients with hip fracture: validating a simple bedside test

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