PREVALENCE AND IMPACT OF GLAUCOMA AMONG THE VERY ELDERLY

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DESCRIPTION: (Applicant's Abstract) Glaucoma prevalence increases with age with rates as high as 5% among whites and 10% among blacks in their seventies. Previous population-based surveys give poor estimates of the prevalence of glaucoma among those over 75 years of age. The proposed research will obtain solid estimates of glaucoma prevalence rates among the most rapidly increasing segment of the United States population, individuals 75 years of age and older. The planned research will supplement an already scheduled evaluation of a large multiracial cohort of older individuals that will take place in June 2001 in Eastern Maryland. The Salisbury Eye Evaluation project (SEE), initiated in August 1992, is an ongoing population-based cohort study of 2,520 people who are now 74 to 93 years old. Study participants have not been systematically evaluated for glaucoma. In addition to determining the burden of glaucoma among the oldest old, the proposed study will assess the impact of visual field loss on function. SEE investigators are not only collecting patient-reported assessments of their ability to perform activities of daily living, they are also administering performance-based tests of physical function. These include tests of balance, mobility and performance of routine tasks. The current proposal, by improving the quality of visual field testing and providing eye examinations by glaucoma specialists will not only identify glaucoma cases, but will also determine the impact of varying degrees of glaucomatous and non-glaucomatous visual field loss on function. Specifically, the current research will explore the effect of visual field loss on patient mobility, patient-reported falls and fear of falling, and limitations in activities of daily living. The extensive data being collected on physical and cognitive comorbidities will allow for adjustments in the analysis so that the impact of visual field loss can be assessed independently from these factors. Finally, the interactions between comorbidities (including cognitive deficits) and visual field loss will be explored.