Depression, loneliness, and lower social activity as partial mediators of the association between visual impairment and cognitive decline.

OBJECTIVES: Sensory impairment is a hypothesized risk factor for cognitive decline; however, the psychosocial pathways are not well understood. We evaluated whether the association between visual impairment (VI) and cognitive decline was partially mediated via depressive symptoms, loneliness, or social activity. METHODS: We used data from 2601 older adults enrolled in the Memory and Aging Project in 1997 and the Minority Aging Research Study in 2004 with neuropsychological tests across five domains measured annually for up to 16 years. VI was assessed with the Rosenbaum Pocket Vision Screener. Depressive symptoms, loneliness, and social activity were self-reported using validated scales. We used structural equation models to estimate the associations of VI with baseline and change in cognitive function, directly and indirectly through each mediator (depressive symptoms, loneliness, and social activity). We evaluated mediation via "psychological distress" using a latent variable combining depressive symptoms and loneliness. RESULTS: The association between VI and global cognitive decline was mediated via lower social activity (indirect effect) [95% confidence interval (CI)] of linear slope: -0.025 (-0.048, -0.011), via loneliness (-0.011 [95% CI: -0.028, -0.002]), and via psychological distress (-0.017 [95% CI: -0.042, -0.003]). We did not find sufficient evidence for mediation via depressive symptoms alone. CONCLUSIONS: The harmful effect of VI on cognitive decline may be partially mediated through loneliness and lower social activity.

Patient activation in adults with visual impairment: a study of related factors.

This study aims to analyze variables related to patient activation in 78 individuals with visual impairment. The Patient Activation Measure (PAM) scores of participants showed no differences between males and females. It was found that the individuals living in urban areas, and participants with higher income and education levels had higher PAM scores. Still, the difference between the groups was statistically insignificant (p > 0.05). The PAM scores of the visually impaired individuals reflect taking action level of activation (66.51 ± 18.14-PAM level 3). There was a moderately significant relationship between PAM scores and visually impaired individuals' self-management, self-efficacy, healthy life awareness, social relations, and environment (p < 0.001). We found that the variables included in the regression model (marital status, self-management, self-efficacy, healthy life awareness, social relations, and environment) explained 72.2% of the PAM score. Individuals with visual impairment can be given training on self-management, self-efficacy, healthy life awareness, and quality of life associated with social relations and environment to develop positive health behaviors.

[Association between emotional disorders and ophthalmopathology in residents of the Arkhangelsk region at the age of 60-74 years.]

A study was conducted to investigate the associations of the diseases of the organ of vision and its accessory apparatus with anxiety and depression in the elderly people. The study included 678 participants of the ESSE-RF3 population study in the Arkhangelsk region in the age of 60-74 years. We used a questionnaire, including the hospital scale of anxiety and depression score (HADS), and the assessment of the ophthalmological status. It was found that all the study participants had diseases of the visual organ. Elevated depression scores were associated with sex, age, marital status (being single), and disability, elevated anxiety scores - with sex. The scores on the anxiety scale were on average 25% higher in participants whose visual acuity decreased to 0,5 units, and showed no independent associations with diagnosed ophthalmological diseases. The scores on the depression scale were on average 33% higher in participants with visual acuity 0,5 units, and 22% higher in the presence of retinopathy. In conclusion, anxiety and depression in the elderly people were more associated with visual deficits rather than with the presence of ophthalmological diseases underlying a decrease in functional status.

Perceptions of vision care following neurological impairment: a qualitative study.

BACKGROUND: Visual impairment is a common consequence of neurological impairments, and can impact a person's ability to undertake everyday tasks, affecting their confidence and mental health. Previous qualitative research in the UK has shown inequalities to exist where patients are accessing vision care after stroke, but little is known around the experiences of accessing vision care following other neurological impairments, and a lack of national guidelines prevent standardised care planning. The aim of this qualitative study is to explore the perceptions of vision care after neurological impairment, and to identify possible inequalities and support mechanisms, where it has been possible to access vision care. METHODS: University ethical approval was obtained, and adults with a visual impairment as a result of a neurological impairment were offered an in-depth interview to explore their vision care experiences. Data were collected between April and November 2021 and analysed using iterative, thematic analysis (TA), informed by a social constructionist ideology. RESULTS: Seventeen participants were recruited. Three overarching themes were conceptualised in relation to the participants' perception of vision care: Making sense of the visual impairment; The responsibility of vision care; and Influential factors in care quality perception. CONCLUSION: Inequalities were noted by participants, with most reporting a lack of suitable vision care offered as part of their neurological rehabilitation. Participants were thus burdened with the task of seeking their own support online, and encountered inaccurate and worrying information in the process. Participants noted changes in their identity, and the identity of their family carers, as they adjusted to their vision loss. The findings from this research highlight a need for clinicians to consider the long-term impact of vision loss after neurological impairment, and ensure patients are provided with adequate support and information, and appropriate referral pathways, alleviating this patient burden.

Cross-sectional study of prevalence and correlates of fear of falling in the older people in residential care in India: the Hyderabad Ocular Morbidity in Elderly Study (HOMES).

OBJECTIVE: To report the prevalence and risk factors for the fear of falling (FOF) among older individuals living in residential care facilities in India. DESIGN: Cross-sectional study. SETTING: Homes for the aged centres in Hyderabad, India. PARTICIPANTS: The study included individuals aged ≥60 years from homes for the aged centres. The participants underwent a comprehensive eye examination in make-shift clinics setup in homes. Trained investigators collected the personal and demographic information of the participants and administered the Patient Health Questionnaire-9 and Hearing Handicap Inventory for Elderly questionnaire in the vernacular language. FOF was assessed using the Short Falls Efficacy Scale. The presence of hearing and visual impairment in the same individual was considered dual sensory impairment (DSI). A multiple logistic regression analysis was done to assess the factors associated with FOF. PRIMARY OUTCOME MEASURE: FOF. RESULTS: In total, 867 participants were included from 41 homes for the aged centres in the analyses. The mean (±SD) age of the participants was 74.2 (±8.3) years (range 60-96 years). The prevalence of FOF was 56.1% (95% CI 52.7% to 59.4%; n=486). The multivariate analysis showed that those with DSI had eleven times higher odds of reporting FOF than those with no impairment (OR 11.14; 95% CI 3.15 to 41.4.) Similarly, those with moderate depression had seven times higher odds (OR 6.85; 95% CI 3.70 to 12.70), and those with severe depression had eight times higher odds (OR 8.13; 95% CI 3.50 to 18.90) of reporting FOF. A history of falls in the last year was also associated with increased odds for FOF (OR 1.52; 95% CI 1.03 to 2.26). CONCLUSION: FOF is common among older individuals in residential care in India. Depression, falling in the previous year and DSI were strongly associated with FOF. A cross-disciplinary approach may be required to address FOF among the older people in residential care in India.

Relationship between self-reported hearing and vision problems, cognitive decline, depressive symptoms, and life satisfaction in older adults: a retrospective observational study.

BACKGROUND: Sensory impairment in older adults is associated with cognitive decline, elevated depressive symptoms, and low levels of life satisfaction. However, these relationships are usually investigated separately and in pairs. This study examined these relationships comprehensively, for the first time. METHODS: The analysis included 5,658 community-dwelling older adults from the China Health and Retirement Longitudinal Study (aged 50 to 108 years, 52.1% male) who completed the Jorm Informant Questionnaire Cognitive Decline in the Elderly and the Center for Epidemiological Studies-Depression-short form. A questionnaire was used to collect information on hearing, visual status, and life satisfaction. Structural equation modelling was used to examine the direct and indirect relationships between these variables. RESULTS: Self-reported hearing and vision problems are directly associated with cognitive decline and elevated depressive symptoms. In addition, hearing and vision problems are indirectly related to cognitive decline through elevated depressive symptoms. Although hearing and vision problems had no direct effect on life satisfaction, they were indirectly associated with life satisfaction through cognitive decline and depressive symptoms. CONCLUSIONS: This study provides the first epidemiological evidence of the comprehensive relationships between hearing and vision problems, cognitive decline, depressive symptoms, and life satisfaction. When older adults report hearing and/or vision problems, clinicians and caregivers should be aware of the concurrence of declined cognition, elevated depressive symptoms, and compensated life satisfaction. Future studies should examine the causal relationships and potential mechanisms of these relationships.

Association Between Multisensory Impairment and Depression Among Older Adults: A Population-Based Analysis.

OBJECTIVE: In this study, we examine how impairments in vision, hearing, touch, and olfaction relate to depression in older adults, considering both individual and multisensory impairments (MSIs). STUDY DESIGN: Analysis of cross-sectional data from a longitudinal investigation involving black and white older adults aged 70 to 79 at enrollment. SETTING: We studied 1640 black and white participants in the Health ABC study using complete sensory evaluation data from years 3 to 5. METHODS: Our MSI assessment utilized data obtained for visual acuity, hearing perception, olfactory performance, and tactile function. We performed multivariable logistic regression analyses to examine the associations between the presence of individual and MSIs and depression which was defined as the presence of antidepressants prescribed for depression, or a Center for Epidemiological Studies Depression Scale score of greater than 10. RESULTS: We observed a possible dose-response relationship between the number of sensory impairments and depression. In adjusted models, when compared to no impairments, vision (odds ratio [OR] = 1.45, 95% confidence interval [CI]: 1.09-1.93) and hearing impairments (OR = 1.49, 95% CI: 1.11-1.99) were significantly associated with depression, whereas olfaction (OR = 1.11, 95% CI: 0.83-1.47) and tactile impairments (OR = 1.28, 95% CI: 0.96-1.70) were not. Participants with 3 sensory impairments had a higher rate of depression (OR = 2.05, 95% CI: 1.22-3.54) compared to those without impairments, and this risk increased further for those with 4 sensory impairments (OR = 2.95, 95% CI: 1.48-5.88). CONCLUSION: The findings suggest that individuals with MSI represent a high-risk population for depression, warranting close monitoring to screen for depression. The study emphasizes the importance of considering multiple sensory impairments in the context of mental health and supports the early identification and monitoring of depression in this population.

Investigating the Link Between Subjective Depth Perception Deficits and Objective Stereoscopic Vision Deficits in Individuals With Acquired Brain Injury.

Individuals with acquired brain injury have reported subjective complaints of depth perception deficits, but few have undergone objective assessments to confirm these deficits. As a result, the literature currently lacks reports detailing the correlation between subjective depth perception deficits and objective stereoscopic vision deficits in individuals with acquired brain injury, particularly those cases that are characterized by a clearly defined lesion. To investigate this relationship, we recruited three individuals with acquired brain injury who experienced depth perception deficits and related difficulties in their daily lives. We had them take neurologic, ophthalmological, and neuropsychological examinations. We also had them take two types of stereoscopic vision tests: a Howard-Dolman-type stereoscopic vision test and the Topcon New Objective Stereo Test. Then, we compared the results with those of two control groups: a group with damage to the right hemisphere of the brain and a group of healthy controls. Performance on the two stereoscopic vision tests was severely impaired in the three patients. One of the patients also presented with cerebral diplopia. We identified the potential neural basis of these deficits in the cuneus and the posterior section of the superior parietal lobule, which play a role in vergence fusion and are located in the caudal region of the dorso-dorsal visual pathway, which is known to be crucial not only for visual spatial perception, but also for reaching, grasping, and making hand postures in the further course of that pathway.

Young adults with vision impairment in India: Loneliness and social networks.

PURPOSE: To examine the prevalence of loneliness and associated factors in young adults with vision impairment (VI), including quality of life (QoL) in India. METHODS: Two hundred and three VI young adults (18-35 years) and 219 age-matched non-VI (controls) adults completed the loneliness scale, WHOQOL-BREF, Social Network Index (SNI) (network diversity, people in network size and number of embedded network subscales) and questions regarding sociodemographic characteristics and independent mobility. Rasch analysis was used to validate the questionnaires and interval-level scores were generated. Generalised linear models were used to estimate independent associations of sociodemographic factors, VI characteristics, social networks and QoL with loneliness. RESULTS: The prevalence of moderate and severe loneliness in the VI group was 10% (95% CI: 6.5, 15.4) and 4.4% (95% CI: 2.0, 8.2), respectively, and higher than that of controls. The VI group had a worse loneliness score than controls (-1.66 ± 2.25 vs. -2.13 ± 1.85 logits; p = 0.03). Those with ≤12 years and >12 years of education had loneliness scores of -1.58 ± 2.45 and -1.82 ± 1.99 logits, respectively (p = 0.01). Compared with controls, the VI group reported fewer extended family members, neighbours and friends leading to significantly smaller networks and network diversity (all p < 0.001). Loneliness scores demonstrated a significant correlation with only two SNI subscales for both groups: people in network size (r = -0.28 for VI; r = -0.30 for non-VI; p < 0.001 for both) and number of embedded networks (r = -0.22 for VI; r = -0.21 for non-VI; p = 0.002 for both). Both education (ß = 0.45; p = 0.04) and QoL (ß = -0.27, p = 0.02) were predictors of loneliness. CONCLUSIONS: Loneliness was commonly experienced by young VI adults and was higher among those with lower levels of education. Loneliness decreased with the presence of a larger number of people in network, suggesting that interventions to increase social activity and participation may be valuable in young VI adults.

Improving medication dispensing and counselling for patients with vision impairment: a qualitative study of pharmacist-reported barriers and facilitators.

BACKGROUND: People with vision impairment encounter many difficulties when it comes to medicines use. However, evidence indicates that there are major gaps in pharmaceutical care service provision worldwide and limited research on interventions to optimise medication use for this patient population. The Theoretical Domains Framework (TDF) provides a method for theoretically understanding individuals' behaviour and informing development of interventions. The aim of this research was to (a) identify the barriers and facilitators to the provision of medication dispensing and counselling services by pharmacists to patients with vision impairment, and (b) identify key TDF domains to be targeted in a future intervention. METHODS: Semi-structured interviews were conducted with pharmacists from different pharmacy practice settings/areas in Saudi Arabia. The 14-domain TDF was utilised as the theoretical lens through which pharmacists' behaviours were examined. Interviews were conducted in Arabic or English, either face-to-face or over the telephone based on the participant's preference. Following transcription, interviews conducted in Arabic were translated into English before analysis. Data analysis involved using the framework method and content analysis to identify important barriers and facilitators to the provision of dispensing and counselling services to those with vision impairment. Key TDF domains that could be targeted in a future intervention were then identified using a consensus-based approach. RESULTS: Twenty-six pharmacists were interviewed. Pharmacists' experience in pharmacy practice ranged from two to 28 years. A range of barriers and facilitators were highlighted as important in providing services to those with vision impairment. Eight domains were identified as 'key domains' including: 'Knowledge', 'Skills', 'Beliefs about capabilities', 'Goals', 'Memory, attention, and decision processes', 'Environmental context and resources', 'Social influences', and 'Behavioural regulation'. CONCLUSIONS: Barriers and facilitators identified by pharmacists will inform the development of an intervention to ensure its applicability to everyday practice. Future research will focus on the process of developing the proposed intervention through targeting key TDF domains to improve medication dispensing and counselling by pharmacists to patients with vision impairment.

Investigating physical activity levels in adults who are blind and vision impaired.

BACKGROUND: It is well established that meeting physical activity (PA) guidelines has a range of physical and mental health benefits. For people who are blind and vision impaired (BVI) there may be additional benefits in terms of social inclusion and the prevention of sight deterioration. OBJECTIVE: This study aimed to quantify PA levels, barriers to and motivators for PA in adults who are BVI. METHODS: PA levels, perceived barriers to, and motivators for PA were measured via questionnaire of 310 self-identifying BVI adults (n = 310 mean age = 29.77 ± 11.37, 55.8% male). RESULTS: PA levels were low, with 21.7% meeting PA guidelines. Median PA levels were not statistically significantly different between different age groups. There was no significant difference between genders, though mean days of PA for males was 0.382 days lower than for females. There was a significant difference between PA levels between the "no vision" (B1) and "useful vision" (B3) groups (p = 0.027), and the "no vision" (B1) and the "low vision" (B2) groups (p = 0.003). Transport (54.8%) and lack of access to enjoyable activities (47.0%) were the most commonly cited barriers, while "to relax" (36.4%) and "to have fun" (35.6%) were most commonly cited as very important motivators. CONCLUSIONS: This study provides a valuable insight into the low levels of PA that persist amongst adults with BVI. Future research should seek to gain a deeper understanding of the PA barriers, motivators and facilitators in this cohort.

Social engagement and cognitive impairment among nursing home residents: The role of sensory impairment.

BACKGROUND AND OBJECTIVES: Using US national nursing home data, this cross-sectional study sought to evaluate 1) the association between lack of social engagement and level of cognitive impairment; and 2) the extent to which this association differs by hearing and visual impairment. RESEARCH DESIGN AND METHODS: Our sample included 793,846 nursing home residents aged ≥ 50 years. The Index of Social Engagement was categorized as none/lower (0, 1, 2) or higher levels (3 through 6). Cognitive Performance Scale was grouped as intact/mild (0, 1, 2), moderate (3, 4), or severe (5, 6). Multinomial models provided adjusted odds ratio (aOR) and 95 % confidence intervals (CI) between none/lower social engagement and cognitive impairment. We estimated relative excess risk due to interaction (RERI) to quantify the joint effects of social engagement and sensory impairment types. RESULTS: Overall, 12.6 % had lower social engagement, 30.3 % had hearing impairment, and 40.3 % had visual impairment. Compared to residents with high social engagement, those with lower social engagement were more likely to have moderate/severe cognitive impairment (aORmoderate = 2.21, 95 % CI 2.17-2.26; aORsevere = 6.49, 95 % CI 6.24-6.74). The impact of low social engagement on cognitive impairment was more profound among residents with hearing impairment and/or visual impairment (RERIhearing = 3.89, 95 % CI 3.62-4.17; RERIvisual = 25.2, 95 % CI 23.9-26.6)). DISCUSSION AND IMPLICATIONS: Residents with lower social engagement had higher levels of cognitive impairment. Residents with sensory impairments are potentially more susceptible to the negative impact of lower levels of social engagement on level of cognitive impairment.

Evaluation of the test-retest and inter-mode comparability of the Impact of Vision Impairment questionnaire in people with chronic eye diseases.

PURPOSE: The main objective of this study is to assess the test-retest and inter-administration mode reliability of the Impact of Vision Impairment profile (IVI), a common patient-reported outcome measure (PROM) for people with chronic eye diseases. METHODS: The IVI was administered to adult patients with stable, chronic eye diseases two to four times per participant (average intervals between administrations 12 to 20 days; maximum two phone interviews, paper administration, electronic administration) by two trained interviewers. Rasch models were fit to the data. Intra-class correlation coefficients (ICCs), mean differences and Cronbach's alpha between test-retest administrations (two phone interviews) and inter-mode comparisons were calculated. RESULTS: Two hundred-sixteen patients (mean age 67 ± 12 years, 40% male) were included in the study. The IVI met all psychometric requirements of the Rasch model, and the division into the domains of functional items (IVI_F) and emotional items (IVI_E) corresponded to the German validation study. ICCs (all for IVI_F and IVI_E, respectively) for the retest administrations were 0.938 and 0.912, and 0.853 and 0.893 for inter-mode comparisons phone/paper, 0.939 and 0.930 for phone/electronic, and 0.937 and 0.920 for paper/electronic (all p < 0.01). Mean differences (all for IVI_F and IVI_E, respectively) for the retest administrations were 2.8% and 0.7% and ranged from 2.0% to 6.2% and from 0.4 % to 4.9% between administration modes. Cronbach's alpha ranged from 0.886 to 0.944 for retest and inter-mode comparisons. CONCLUSION: Due to the high test-retest reliability and the almost equally high comparability of different modes of administration of the IVI, the study endorses its use as a robust PROM to capture vision-related quality of life. Our results further support the use of the IVI as an endpoint in clinical trials and may simplify implementing it in both clinical trials or real-world evidence generation by offering multiple administration modes with high reliability.

Self-Reported Vision Loss, Health Status, and Social Participation Among Middle-Aged and Older Adults-Evidence From China.

Social participation is crucial for enhancing senior's well-being and promoting their integration into society. Using nationwide data investigated in China, this study explored the association between self-reported visual impairment, health level, and social participation among Chinese middle-aged old adults. It has been found that (a) the probability and frequency of social participation among middle-aged and older adults with self-reported vision loss were significantly lower than those without vision problems; (b) self-reported vision loss was negatively associated with self-rated health and mental health status, and both were positively associated with social participation; and (c) self-rated health and mental health played a mediating role between vision loss and social participation. The findings suggest that under the framework of active aging, universal vision screening programs and rehabilitation plans for the older adults with visual impairment are exceedingly significant to promote their participation in social activities, thereby enhancing their quality of life.

Everyday Challenges for Individuals Aging With Vision Impairment: Technology Implications.

BACKGROUND AND OBJECTIVES: There are growing numbers of older adults with long-term vision impairment who are likely to experience everyday activity challenges from their impairment in conjunction with age-related changes. Technology has potential to support activity engagement. To develop effective technologies and interventions, we need to understand the context of activity challenges and identify unmet support needs. RESEARCH DESIGN AND METHODS: The Aging Concerns, Challenges, and Everyday Solution Strategies (ACCESS) study is a mixed-method approach to explore everyday challenges of people aging with long-term disabilities. Participants included 60 adults aging with long-term vision impairment (63% female; M age = 67, SD = 4.6) who completed in-depth, structured interviews exploring the nature of everyday challenges and their unmet support needs for activity engagement. We conducted a content analysis using a deductive and inductive approach to build a detailed coding scheme of challenge codes and subcodes. RESULTS: The analyses provided detailed insights about the nature of challenges people aging with vision impairment experience when performing specific instrumental activities of daily living (IADLs) in the context of home maintenance, transportation, shopping/finance, and managing health. Vision-related challenges and participation restrictions were identified for several activities that require reading, navigation, and identification (e.g., shopping, medication management, public transportation). Emergent challenge themes for performing IADLs included personal limitations (e.g., physical, cognitive, financial) and environmental barriers (e.g., accessibility, technology, transportation). DISCUSSION AND IMPLICATIONS: Contextual examples of IADL challenges among individuals aging with vision impairment highlight opportunities for technology design and innovation to support participation in everyday activities.

The impact of sensory impairments and eye diseases on cognitive function in elderly Chinese: The mediating effects of social participation.

Background: Sensory impairments and eye diseases increase the risk of cognitive decline, but little is known regarding their influence on cognitive function in elderly Chinese and the underlying mechanisms. We aimed to explore these influence mechanism from the social participation perspective. Methods: We selected 2876 respondents aged ≥60 from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2013, 2015, and 2018. We assessed sensory impairments and eye diseases based on self-reported responses, and evaluated its relation to social participation and cognitive function by fixed-effects regression and mediation effect analysis over a five-year period. Results: Respondents with visual impairment and cataracts had poor memory and mental status. Compared with near visual impairment, distance visual impairment was associated with a 1.7 times higher likelihood of cognitive decline (correlation coefficient (ß) = -0.051; 95% confidence interval (CI) = -0.065, -0.036)). Respondents with hearing impairment had bad memory (ß = -0.046; 95% CI = -0.065, -0.036), but not mental status. Social participation partially mediated the relationships of sensory impairments and cataracts with cognitive function in elderly Chinese. Individuals with sensory impairments affected by limited social participation reported a faster cognitive decline compared to those with eye disease. Conclusions: We found that sensory impairments and eye diseases were negatively associated with cognitive function. Furthermore, sensory impairments and cataracts influence cognitive function partly via social participation. Our results have important theoretical and practical implications and suggests that early interventions for sensory impairments and eye diseases may improve the cognitive function of elderly people.

Assessing the pool activity level (PAL) checklist for use with people with hearing and vision loss.

BACKGROUND: The PAL is a career-completed assessment that indexes cognitive functional ability to inform individualised support. As hearing and vision loss are prevalent, we assessed the PAL for potential bias with hearing or vision impairment. METHODS: We collected PAL responses for 333 adults aged over 60 years in the UK, France, Canada, Greece and Cyprus. All participants had normal cognition based on self-reported status and normal range scores on a cognitive screening test. Using a Kruskal-Wallis test, we compared PAL item response distributions for people with assessed hearing or vision loss compared to those with normal sensory function. RESULTS: There were no differences in response distributions between hearing or vision impaired groups versus those with normal sensory function on any PAL item. CONCLUSION: The PAL reliably indexes cognitive functional ability and may be used to inform support tailored to individual cognitive level amongst older adults with prevalent hearing and vision impairments.

Prevalence of Mental Ill-Health among Visually Impaired Patients in a Tertiary Institution in Southwestern Nigeria.

BACKGROUND: To study the mental health status of patients with visual impairment in a tertiary institution in Southwestern Nigeria. OBJECTIVES: To determine the mental health status of individuals with loss of vision in Ogbomoso and associated factors. METHODOLOGY: A descriptive cross-sectional study. Questionnaires were administered to obtain information on the socio-demographic characteristics and mental health status. Test for association was done. A total score greater than or equal to 4 out of the 28 items of the General Health Questionnaire was considered a case of mental ill-health. RESULTS: 250 subjects were studied, out of which 126 (50%) were found to have mental ill-health. Statistically significant association was found between age, level of education, occupation, duration of loss of vision, and pattern of loss of vision (p-values < 0.001, 0.020, 0.001, and 0.001 respectively) in bivariate analysis, however, age and pattern of vision loss were not significantly associated with loss of vision in multivariate analysis. Those who lost their vision less than two years from the time of the study had a higher risk of mental health morbidity. Those with sudden vision loss were 3.48 times more likely to have mental health morbidity in bivariate analysis, compared with those with progressive visual loss. CONCLUSION: The prevalence of mental ill-health among people with vision loss is high. Associated factors included level of education, occupation and duration of loss of vision. Predictors of good mental health included younger age group, higher level of education, being employed, longer duration of loss of vision and progressive pattern of vision loss.

CONTEXTE: Étudier l'état de santé mentale des patients atteints de déficience visuelle dans un établissement tertiaire du sud-ouest du Nigeria. OBJECTIFS: Déterminer l'état de santé mentale des personnes souffrant d'une perte de vision à Ogbomoso et les facteurs associés. MÉTHODOLOGIE: Étude descriptive transversale. Des questionnaires ont été administrés pour obtenir des informations sur les caractéristiques sociodémographiques et l'état de santé mentale. Un test d'association a été effectué. Un score total supérieur ou égal à 4 sur les 28 items du General Health Questionnaire a été considéré comme un cas de mauvaise santé mentale. RÉSULTATS: 250 sujets ont été étudiés, dont 126 (50 %) présentaient une mauvaise santé mentale. Une association statistiquement significative a été trouvée entre l'âge, le niveau d'éducation, la profession, la durée de la perte de vision et le type de perte de vision (valeurs p < 0,001, 0,020, 0,001 et 0,001 respectivement) dans l'analyse bivariée, cependant, l'âge et le type de perte de vision n'étaient pas significativement associés à la perte de vision dans l'analyse multivariée. Les personnes ayant perdu la vue moins de deux ans après le début de l'étude présentaient un risque plus élevé de morbidité mentale. Les personnes ayant subi une perte soudaine de la vue étaient 3,48 fois plus susceptibles de souffrir de morbidité mentale dans l'analyse bivariée, par rapport à celles ayant subi une perte progressive de la vue. CONCLUSION: La prévalence de la mauvaise santé mentale chez les personnes souffrant d'une perte de vision est élevée. Les facteurs associés sont le niveau d'éducation, la profession et la durée de la perte de vision. Les facteurs prédictifs d'une bonne santé mentale sont le groupe d'âge le plus jeune, le niveau d'éducation le plus élevé, le fait d'avoir un emploi, la durée la plus longue de la perte de vision et le modèle progressif de la perte de vision. Mots-clés: Déficience visuelle, Mauvaise santé mentale.

Quality of life of caregivers of children with visual impairment: A qualitative approach.

BACKGROUND: Receiving a diagnosis of a child with untreatable visual impairment (VI) may have a negative impact on parents and caregivers, and affect their quality of life (QoL). AIMS: To use a qualitative research approach to determine the impact that caregiving a child with a VI has on the QoL of caregivers in Catalonia (Spain). METHODS: An observational study was designed in which nine parents of children with VI (6 mothers) were recruited following an intentional sampling scheme. In-depth interviews were conducted, and a thematic analysis was performed to identify main themes and subthemes. The QoL domains defined in the questionnaire WHOQoL-BREF guided data interpretation. RESULTS: An overarching theme was defined (the weight on one's shoulders), as well as two main themes (obstacles race and emotional impact) and seven subthemes. QoL was negatively affected by a general lack of knowledge and understanding regarding VI in children and its implications for children and caregivers, whereas social support, gaining knowledge, or cognitive reappraisal had a positive effect. CONCLUSIONS: Caregiving for children with VI affects all QoL domains, resulting in persistent psychological distress. Both administrations and health care providers are encouraged to develop strategies to assist caregivers in their demanding roles.

Correlation between Central Visual Field Defects and Stereopsis in Patients with Early-to-Moderate Visual Field Loss.

PURPOSE: To investigate the association between stereoacuity and the presence of central visual field defects (CVFDs) due to glaucoma. DESIGN: A prospective, cross-sectional cohort study. PARTICIPANTS: Participants with early-to-moderate glaucoma with a visual acuity better than 20/40, less than a 2-line difference in visual acuity between eyes, and 2 reliable Humphrey visual fields (VFs) (24-2 SITA standard) with mean deviation (MD) in the worse eye better than - 12 dB. METHODS: Stereoacuity was measured using the Titmus stereo test. Participants with a significant field defect (P < 0.005) in any 1 of the central 4 points in the 24-2 SITA standard total deviation map in either eye were classified as having a CVFD. Vision-related quality of life (VR-QOL) was measured using 25-item National Eye Institute Visual Function Questionnaire scores. Logistic regression was used to determine the associations between the level of stereoacuity and age, sex, race, glaucoma type, presence of CVFDs, visual acuity, contrast sensitivity, and VF MD. MAIN OUTCOME MEASURES: Stereoacuity in the CVFD and non-CVFD groups. RESULTS: Sixty-five participants met the inclusion criteria. The mean age of the participants was 64.3 ± 8.0 years, and 64.6% were women. The median stereoacuity was 60 arc seconds (interquartile range [IQR], 40-120 arc seconds). Forty-two (65%) patients had CVFDs, and 23 (35%) patients did not. The median stereoacuity of the CVFD group was worse than that of the non-CVFD group (60 arc seconds [IQR, 50-140 arc seconds] vs. 40 arc seconds [IQR, 40-80 arc seconds], respectively; P = 0.001). The non-CVFD group had a higher percentage of participants with normal stereopsis than the non-CVFD group (61% vs. 21%, respectively; P = 0.001). A multivariable analysis found that the presence of CVFDs was associated with worse stereopsis levels (odds ratio, 4.49; P = 0.021). The CVFD group had a lower Visual Functioning Questionnaire-25 (VFQ-25) composite score (84.0 vs. 91.4; P = 0.004) and lower VFQ-25 subscale scores for general vision, near activities, and mental health (P < 0.05). CONCLUSIONS: Central visual field defects were associated with increased odds of poor stereoacuity in patients with early-to-moderate glaucomatous VF loss. Specifically, patients without CVFDs are more likely to have normal stereopsis and higher VR-QOL than those with CVFDs. Patients with CVFDs should be counseled regarding how depth perception difficulties may affect daily living. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.