Trajectories of vision in older people: the role of age and social position

Abstract

Visual impairment becomes more prevalent with age. Rather than a uniform decline in vision with age, the strength and direction of change varies between people. This study applies an analytical method that posits multiple trajectories in eyesight, allowing for a more specific description of developmental course of this health outcome and its relationship with social position. The analysis uses the responses of 2956 respondents, aged 60 years and over, followed over 8 years (five observations) as part of the English longitudinal study of ageing. At each observation respondents self-reported their general vision. Optimal matching (sequence analysis), hierarchical clustering, and multinomial logistic regression were used to describe the sequential data, produce a typology of vision trajectories, and examine the socio-demographic characteristics associated with different trajectories. Eight distinctive clusters of trajectories were identified. The probability of reporting different types of vision trajectory varies with a change in age; however, the magnitude of the age effect is associated with social position. Visual impairment in older people is an increasingly relevant area for policy focus, with the rapid growth and diversity of the older population. Identifying factors underpinning the patterning of changes in visual function is essential for developing evidence-based policy, which both meets the needs of those most at risk and increases cost-effectiveness of public health interventions.

The consequences of self-reported vision change in later-life: evidence from the English Longitudinal Study of Ageing

“…As with all longitudinal data there are potential problems associated with attrition within the ELSA dataset, with individuals who are in poorer health and poorer wealth circumstances increasingly likely to drop out of the study over time 29 . Poorer vision shows associations with both of these factors, and previous research using ELSA and self-reported vision have shown a higher proportion of individuals have better levels of self-reported vision than the actual population of people aged 50 and over in England 16 . As a result, the findings of the current research are likely to be underestimated compared to the potential findings unaffected by this attrition.…”

“…Previous research has highlighted socio-economic factors are likely to influence both deterioration in vision as well as uptake of measures to improve impaired vision or prevent sight loss. Both onset of vision impairment and deterioration in vision occur at greater magnitudes among older people in poorer social circumstances 16,17 . This group are more likely to be deterred from using eye health services due to potential treatment costs, such as the need to purchase glasses 18 .…”

Comparing oculomotor efficiency and visual attention between drivers and non-drivers through the Adult Developmental Eye Movement (ADEM) test: A visual-verbal test

“…It is worth highlighting that the academic level of the subjects was not a potential predictor of the test performance, although significant differences were found in test performances between the basic educational level and both the medium (p < .05) and the high levels (p < .001), but not between the medium and the high level (p>.05). Our results could imply that people with higher levels of academic training had better results in test times, which may be related to factors such as further visual impairment coming with the aging of people in socioeconomic disadvantage [59]. However, the educational level of subjects was excluded from the regression model due to not presenting statistically significant values.…”

Is social participation associated with good self-rated health among visually impaired older adults?: the JAGES cross-sectional study

“…Although self-reported vision status is widely used in epidemiologic research, and its validity has been confirmed, it is not equivalent to objective testing of visual acuity [ 47 , 48 ]. Conversely, self-reported vision status reflects broad aspects of vision that directly affect older adults’ lives under non-ideal conditions, such as low contrast, glare, and low and changing levels of light [ 49 ]. Thus, a self-reported measure may reflect vision with regard to everyday functioning more accurately.…”