Just out of sight: Mild visual impairment and its impact on self-care

background:

Older age and limited health literacy are established barriers to self-management, which is essential to managing one’s overall health.  Mild visual impairment may also be an unrecognized and easily correctible impediment to self-care.  We sought to determine if mild visual impairment was an independent risk factor for worse self-management skills among older adults. 

 

methods:

We used baseline data from a cohort study of 895 older adults, ages 55-74, recruited from an academic internal medicine clinic and six federally qualified health centers in Chicago.   Self-management skills were measured using a validated, objective assessment of performance on everyday health tasks. Vision with corrective lenses was assessed with the Snellen [normal (20/20 – 25/20) vs. near normal (20/30 – 20/50)].  We modeled visual acuity predicting health task performance with linear regression, controlling for age, race, health literacy, number of chronic conditions and prescription medications.  

 

results:

Participants’ mean age was 63 years; 69% were women, 45% African American, and 30% had limited health literacy.  Normal vision was associated with better overall health task performance (β 2.57; 95% CI 0.48-4.59, p<.05), with greatest detriment in recalling health information conveyed via multimedia (β 4.19; 95% CI 0.66-7.65, p<.05), and accurately dosing multi-drug regimens (β 2.68; 95% CI 0.00-5.37, p=.05). A non-significant trend was found for interpreting medical information on print documents (β 1.99; 95% CI -0.44-4.42, p=.10).   

 

conclusions:

Public health initiatives that target mild visual impairment within a normal range may improve self-care behaviors.  Health systems and relevant industries should consider this when designing health information, materials and devices.