MULTIDIMENSIONAL INTERVENTION FOR VISION-IMPAIRED ELDERS

University Of California Los Angeles, Los Angeles CA

Investigators

Linked publications & trials

Abstract

Description: (provided by the applicant) Visual impairment is very common in older persons and is associated with decreased vision-specific and overall functioning. Two of the most common causes of visual impairment, uncorrected refractive error and cataracts, are reversible, while the others, such as glaucoma and age-related macular degeneration, are not. No matter whether visual impairment is irreversible or reversible, visual functioning may improve with increased lighting and the use of low vision aids. The proposed Intervention Development Study (IDS) is designed to provide enough information to support an application for a Randomized Clinical Trial (RCT) to determine whether visual and overall functioning of older persons can be enhanced through a multi-dimensional intervention that corrects reversible causes of visual impairment, improves lighting in the home environment, and provides access to low vision aids. The IDS is designed so that it will provide critical information about the feasibility, recruitment rates, expected effect sizes, and costs that would be associated with a RCT. During phase I, participants will have their visual functioning optimized through cataract surgery or new eye glasses. Subjects with visually significant cataracts will be referred for cataract surgery. Subjects in whom their vision can be improved with new eyeglasses (uncorrected refractive error) will be randomized to either receive an updated prescription and voucher for new eyeglasses immediately or receive the updated prescription and voucher for new eyeglasses 3 months later. The impact of correction of uncorrected refractive error (e.g., new eyeglasses) on vision-related quality of life measures will be investigated in phase I. Subjects with visual functioning that cannot be improved with cataract surgery or new eye glasses because of age-related macular degeneration or glaucoma will be followed during phase I. In phase II, all participants will be randomized to either an intervention aiming to improve lighting conditions in the home environment or a control condition of changing existing light bulbs in the home. Following a factorial design, a subset of individuals with near vision worse than 20/40 will be randomized to the provision of low vision aids and training on their use. Primary outcomes of the study will be measures of vision-related quality of life and measures of functioning.