Function and visual impairment in a population-based study of older adults - The SEE project

Purpose. The Salisbury Eye Evaluation (SEE) project investigates the impact of vision on functional statics in a population-based sample of elderly persons. The prevalence of self-reports of functional status and the association with visual acuity loss are described. Methods. A random sample of men and women 65 to 84 years of age from Salisbury, Maryland were recruited for home interviews and clinic examinations. Of the eligible sample, 78% responded to the home questionnaire and 65% responded to the questionnaire and the clinic examination. Binocular visual acuity of each person was measured using; ETDRS charts and protocols. Questions were asked concerning activities of daily living, instrumental activities of daily living, physical function, social interaction, and activities of daily vision. Analyses of the association of presenting visual acuity worse than 20/40 with the measures of function were carried out and adjusted for age, race, and sex. Results. All measures of functional status showed a decline with age; women and blacks were more likely to report difficulties. The age-adjusted proportions of those with visual impairment were not significantly different between men and women (7.2% versus 6.7%; P = 0.60). Black persons had almost mice the rate (10.4%) of white persons (5.6%; P < 0.001). Age, race, gender, and visual impairment were all significantly related to declines in functional status in multivariate models. Conclusions. Data on functional status in the project population were similar to national data and confirmed higher rates of disability in women and blacks. Binocular visual acuity worse than 20/40 appeared to have an impact on all the self-report measures of functional status. Further analyses on the interaction of vision with other comorbid conditions on function status clearly are indicated.