Changes in vision impairment among older adults over time

Objective: To evaluate the variability and consequences of vision impairment among older adults over time.

Methods: Using data from the three time points (baseline, Wave 2 and Wave 3) of the second Longitudinal Study of Aging (1994-2000), we evaluated how reported vision impairment changes among adults who were 70+ years at baseline and the relationship of vision impairment to entry into assisted living facilities, self-reported fair/poor health, and death.

Results: Preliminary results indicate a substantial proportion of respondents reporting vision impairment at baseline or Wave 2 report no trouble seeing during the subsequent interview (38% of survivors at Wave 2, 34% at Wave 3). Additionally, presence of vision impairment at any prior time point had an increased association with entry into assisted living facilities (Wave 2 AOR=1.43, p=0.0018; Wave 3 AOR=1.66, p<0.0001), self-reported fair/poor health (Wave 2 AOR=1.45, p=0.0001; Wave 3 AOR=1.49, p<0.0001) and death (Wave 2 AOR=1.43, p=0.0002; Wave 3 AOR=1.44, p<0.0001) after controlling for age, race, gender and number of other medical conditions. Differences are still significant when controlling for specific concurrent medical conditions such as diabetes and history of stroke.

Conclusions: We found there to be substantial fluidity in visual impairment status over time among adults older than 70 years. While the vision of many people improved (mainly through cataract removal), a substantial proportion reported dramatic declines, often leading to institutionalization, poorer health and death. These dynamic circumstances suggest the importance of health, public health and rehabilitation interventions to improve a variety of outcomes.