Characterizing Vision Impairment and Its Impact on Independence in Older Adults

摘要 视力障碍（VI）是老年人中的一个重要公共卫生问题。VI影响范围广泛， 活动，并与生活质量下降和较差的身心健康。随着人口 随着年龄的增长，VI将成为一个越来越重要的问题。然而，年龄最大的老年人（80岁以上）的VI数据如下： 有限公司现有的数据表明，一个显着比例的老年人有未矫正的屈光不正 (URE)- 这种情况很容易用眼镜解决-以及视力限制性白内障。而距离 视敏度是VI最常用的测量方面，即对比敏感度（CS;区分视力的能力）。 低光环境中的物体）对于许多活动也是重要的。然而，很少有基于人口的研究 测量老年人的对比敏感度;需要数据来了解远视力的影响， 对比敏感度不足的老年人。 在这项研究中，我们将增加远视力和CS测试已经资助，一次性访问的家庭， 4 200名老年妇女参加妇女健康倡议近30年。这些数据 将用于描述VI在最年长老年人中的患病率（目标1），并评估VI对 社会、心理、认知和身体健康指标（目标2）。如果有一个独特的机会， 正在进行的队列研究，我们将能够描述横断面相关性（目标2a），并前瞻性评估 功能下降的轨迹（目标2b）。此外，我们将利用WHI-Medicare索赔链接来分析 VI与医疗保健利用和成本之间的关联（目标2c）。我们将推荐眼部护理， VI患者和将表征寻求护理的人与不寻求护理的人之间的差异， 审查报告的护理障碍（目标3a）。通过聘请患者护理导航员，我们的目标是帮助促进护理 对于那些最初不寻求它的人，我们将评估患者护理导航对 提高所需眼部护理的利用率（目标3b）。 将这些视觉测量添加到WHI数据的丰富存储库中，为评估 VI在广泛的健康领域中的作用。项目成果将用于制定干预措施， 老年人的视力健康，最终目标是延长独立性和提高生活质量， 老年人著名的视觉专家强调，需要获得VI的质量估计， 最古老的老年人，以便卫生系统准备为日益增长的受影响人口提供服务。这 一个创新的项目填补了我们对VI及其对我们社会最年长者生活影响的知识的重要空白 成员

ABSTRACT Vision impairment (VI) is a significant public health problem among older adults. VI impacts a broad range of activities and is associated with reduced quality of life and poorer physical and mental health. As the population is aging, VI will become an increasingly important problem. Yet, data on VI in the oldest old (aged 80+) are limited. Available data suggest that a significant proportion of older adults have uncorrected refractive error (URE) – a condition that is easily addressed with spectacles – as well as vision-limiting cataract. While distance visual acuity is the most commonly measured aspect of VI, contrast sensitivity (CS; the ability to differentiate objects in low light settings) is also important for many activities. However, few population-based studies have measured contrast sensitivity in older adults; data are needed to understand the impact of distance acuity and contrast sensitivity deficits in the oldest old. In this study, we will add distance visual acuity and CS tests to an already funded, one-time visit in the homes of 4,200 older women who have participated in the Women’s Health Initiative (WHI) for nearly 30 years. These data will be used to characterize the prevalence of VI in the oldest old (Aim 1) and to assess the impact of VI on social, psychosocial, cognitive, and physical health indicators (Aim 2). Given the unique opportunity to link to an ongoing cohort, we will be able to describe cross-sectional associations (Aim 2a) and to prospectively evaluate trajectories of functional decline (Aim 2b). Additionally, we will utilize the WHI-Medicare claims link to analyze associations between VI and healthcare utilization and costs (Aim 2c). We will recommend eye care for individuals with VI and will characterize differences between those who seek care vs. those who do not and will examine reported barriers to care (Aim 3a). By engaging a patient care navigator, we aim to help facilitate care for those who do not initially seek it, and we will evaluate the potential impact of patient care navigation on improving uptake of needed eye care (Aim 3b). Adding these vision measures to the rich repository of WHI data provides a unique opportunity to evaluate the role of VI on a broad range of health domains. Project results will be used to develop interventions to improve vision health in older adults, with the ultimate goal of extending independence and improving quality of life in older adults. Renowned vision experts have highlighted the need for obtaining quality estimates of VI in the oldest old, in order for health systems to prepare for serving the growing population of affected individuals. This innovative project fills an important gap in our knowledge of VI and its impact on the lives of our society’s oldest members.