552 Medical Abstracts

How do visual andcognitive impairmentsaffect health-relatedquality of life in nursinghome residents?

Elliott AF, Mc Gwin G Jr, Owsley C.Health-related quality of life andvisual and cognitive impairmentamong nursing-home residents. Br JOphthalmol 2009;93(2):240-3.

Visual and cognitive impairmentshave been documented to be moreprevalent among older adults residingin long-term care facilities comparedwith the same population living inde-pendently at home. These impair-ments have been proven to have anegative impact on an individual’shealth-related quality of life(HRQoL). Researchers in this cross-sectional study attempted to determinehow visual and cognitive impairmentsimpact the HRQoL in nursing homeresidents.

A total of 382 individuals from 17nursing homes from the Birmingham,Alabama, area were enrolled. Partici-pants in the study were required to

speak English, be at least 55 years old,and have a score of at least 13 on theMini Mental State Exam (MMSE). Inaddition to demographic information(age, sex, race, and education), currentmedical conditions were reviewedfor each person. Near visual acuitywas measured using Lighthouse NearVisual Acuity Test at 40 cm. Threedifferent questionnaires were used toassess the residents’ visual, physical,and mental quality of life. For thepurpose of this study, individuals witha score between 13 and 23 on theMMSE were considered to have cog-nitive impairments. Near visual acuityof worse than 20/60 was consideredvisually impaired. After near testingand questionnaires were completed,the participants were categorized into1 of the 4 following groups: (1) novision or cognitive impairment, (2)vision impairment with no cognitiveimpairment, (3) cognitive impairmentwith no vision impairment, and (4)vision and cognitive impairment.

The category involving vision andcognitive impairments was the largestgroup at 38.5%, whereas the groupwith neither vision nor cognitive im-pairment was 21.5%. Nearly threequarters of the participants were white,

female, and in their 70s and 80s. Otherfindings included the following: nearlyhalf of the participants had at least ahigh school education and an averageof 5 or 6 chronic medical conditions.The study shows both visual and cog-nitive impairment increase with ageand is more common among women,blacks, and individuals with less edu-cation. Furthermore, although visionimpairment does negatively affectHRQoL, there was no significantdifference whether the person hadcognitive impairments or not. Cogni-tive impairment did not influence vi-sion impairments’ effect on HRQoL.

Although it was initially believedhaving both cognitive and visual im-pairments would have a greater effecton the HRQoL, researchers discoveredthere was not a deleterious impact.This is one of the first studies toinclude demographic data and generalhealth problems in addition to visualand cognitive impairments in nursinghome residents. Regardless of the res-idents’ cognitive impairment, improv-ing their visual deficit has been shownto improve their HRQoL.

Stephen Hess, O.D.

doi:10.1016/j.optm.2009.07.009