Impact of Dementia and Visual Impairment on Daily Functioning
By Lynda Seminara
Selected and Reviewed By: Neil M. Bressler, MD, and Deputy Editors
Journal Highlights
JAMA Ophthalmology, July 2020
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Patel et al. looked at a national sample of senior citizens and found that those with dementia plus visual impairment (VI) had greater limitations in self-care, mobility, and other daily activities than would be expected for either condition alone.
For this research, the authors gathered data from the National Health and Aging Trends Study, an annual sampling of U.S. adults 65 years and older. Participants of the 2015 survey who had complete data on outcomes, associated factors, and covariates were included. Main outcome measures were independent associations and interactions of dementia and self-reported VI status on three functional activity scales: self-care, mobility, and household activities. Marginal predicted proportions were calculated, and findings were adjusted for sociodemographic and medical factors.
The final analysis included 7,124 participants, 8.6% of whom reported VI. Probable dementia was present in 6.3% and possible dementia in 8.3%. Self-reported VI was associated with expected score decreases of 14.7% for mobility, 9.5% for self-care, and 15.2% for household activities. For probable dementia, the expected declines were 27.8%, 22.9%, and 34.7%, respectively. Individuals with both VI and probable dementia had the greatest limitations, with score decreases of 50.1% in mobility, 42.4% in self-care, and 52.4% in household activity. This suggests that co-occurring VI and dementia yield poorer functional ability than either of these disabilities alone.
The severe limitations of concurrent VI and dementia show the need for strategies to address this burden. Such efforts should maximize vision, preserve or enhance cognition, and promote functional independence. (Also see related commentary by David S. Friedman, MD, PhD, and Pradeep Y. Ramulu, MD, PhD, in the same issue.)
The original article can be found here.