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Editors Selection IGR 14-3
Quality of Life: Vision loss and daily living disabilities
Comment by Lyne Racette on:
50206 Association of vision loss in glaucoma and age-related macular degeneration with IADL disability, Hochberg C; Maul E; Chan ES et al., Investigative Ophthalmology and Visual Science, 2012; 53: 3201-3206
With the aging of the population, agerelated ocular diseases will affect an increasingly higher number of individuals in the upcoming decades; an increasing number of individuals will also be affected concurrently by more than one ocular disease. It is therefore crucial to gain a better understanding of the impact of visual loss on the ability to live independent and fulfilling lives. Hochberg et al. assessed the impact of two agerelated diseases, glaucoma and age-related macular degeneration (AMD), on instrumental activities of daily living (IADLs). Performance on IADLs was assessed through a questionnaire and focused on self-reported performance on the following activities: preparing meals, grocery shopping, managing one's own money, using a telephone, heavy housework, light housework, getting to places beyond walking distance, and taking medications. Sixty controls, 84 patients with bilateral glaucoma, and 47 patients with bilateral AMD were included. Eighteen percent of controls, 25% of glaucoma patients and 44.7% of AMD patients reported disability on at least one IADL. Overall, the magnitude of difference between the groups was likely underestimated because the controls used in this study were either asymptomatic glaucoma suspects or ocular hypertensives (i.e., controls were not required to have healthy eyes).
Both central and peripheral visual loss adversely affect the performance of instrumental activities of daily living
The three IADLs with the highest frequency of disability were heavy housework, traveling beyond walking distance and grocery shopping. These IADLs are dependent in part on mobility; the relationship between vision, mobility and performance on IADLs should therefore be further explored. Finally, the severity of visual field loss in glaucoma and of visual acuity loss in AMD was positively associated with the number of IADLs on which a disability was reported. Overall, this interesting study shows that both central and peripheral visual loss adversely affect the performance of IADLs. Future studies should measure performance on IADL objectively to determine the accuracy of self-reported IADL disabilities.
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