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Impact of the Severity of Distance and Near-Vision Impairment on Depression and Vision-Specific Quality of Life in Older People Living in Residential Care

¹From the Centre for Eye Research Australia, the Royal Victorian Eye and Ear Hospital, and the ³National Ageing Research Institute, University of Melbourne, Melbourne, Australia; the ²Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; and the ⁴Musculoskeletal Research Centre, Faculty of Health Sciences, La Trobe University and Northern Health, Melbourne, Australia.

PURPOSE. To determine the relationship between the severity of distance and near-vision impairment on vision-specific quality of life (QoL) and depression in residential care residents.

METHODS. Residents from three low-level residential care facilities in Victoria (Australia) were recruited. All participants were assessed for cognitive impairment, distance and near-vision impairment (VI), and depression. Sociodemographic and other clinical data were also collected. The subscales of the Nursing Home Vision-Targeted Health-Related Quality-of-Life questionnaire (NHVQoL) were the main outcome measures and were validated by Rasch Analysis.

RESULTS. Seventy-six residents were enrolled. The mean ± SD of the participants’ age was 83.9 ± 9.9 years, and most were women (n = 44; 60%); 46.4% (n = 35) had binocular presenting VI (<6/12), and 59% (n = 44) had at least mild near VI (worse than N8); 16% (n = 14) recorded depression symptoms, although depression was not associated with VI (P > 0.05). In linear regression models, distance and near VI was independently associated with poorer QoL on seven of the eight subscales of the NHVQoL scale (P < 0.05). The β coefficients ranged from –12.3 to –80.2, which suggests that, on average, people with vision loss had poorer QoL, ranging between 12 and 80 points (scale range: 0–100) than did those with no VI. The QoL aspects most affected by vision loss were related to general vision, reading, hobbies, emotional well-being, and social interaction.

CONCLUSIONS. VI remains a major form of disability in individuals living in residential care facilities and affects vision-specific functioning and socioemotional aspects of daily living. A larger study is needed to confirm these findings.