Purpose-Both optical and electronic magnification are available to patients with low vision. Electronic video magnifiers are more expensive than optical magnifiers, but they offer additional benefits, including variable magnification and contrast. This study aimed to evaluate the effect of access to a video magnifier (VM) added to standard comprehensive vision rehabilitation (VR).Methods-In this prospective study, 37 subjects with central field loss were randomized to receive standard VR (VR group, 18 subjects) or standard VR plus VM (VM group, 19 subjects). Subjects read the International Reading Speed Texts (IReST), a bank check, and a phone number at enrollment, at 1 month, and after occupational therapy (OT) as indicated to address patient goals. The Impact of Vision Impairment (IVI) questionnaire, a version of the Activity Inventory (AI), and the Depression Anxiety and Stress Scale (DASS) were administered at enrollment, 1 month, after OT, 1 month later, and 1 year after enrollment. Assessments at enrollment and 1 month later were evaluated.Results-At 1 month, the VM group displayed significant improvement in reading continuous print as measured by the IReST (P = 0.01) but did not differ on IVI, AI, or DASS. From enrollment to 1 month all subjects improved in their ability to spot read (phone number and check; P < 0.01 for both). The VM group improved in their ability to find and read a number in a phone book more than the VR group at 1 month after initial consultation (P = 0.02). All reported better well-being (P = 0.02).Conclusions-All subjects reported better well-being on the IVI. The VM group read faster and was better at two spot reading tasks but did not differ from the VR group in other outcome measures.

Critical review Introduction Life for adults aged 65 years and older has changed dramatically over the years. Since individuals are living longer, today's healthy older adult spends approximately a third of his or her life in retirement (Bass-Haugen et al 2005). Most of these older adults are not sedentary: they spend about 4 hours a day outside the home, engaging in shopping, driving, cultural and sporting events, volunteering, travelling, and visiting family and friends (Horgas et al 1998). Additionally, many older adults do not retire abruptly but, rather, remain in or return to the workforce (Bass-Haugen et al 2005). These social, leisure and productive occupations maintain quality of life, self-efficacy, and physical and mental health (Stevens-Ratchford 2005). However, activity engagement decreases in the presence of health conditions such as low vision, which have an impact on daily functioning (Bass-Haugen et al 2005). Of the estimated 314 million people with visual impairments worldwide, approximately 82% are above the age of 50 years (World Health Organisation 2009). These individuals are in need of unique rehabilitation treatment plans to enable their occupational engagement. People with low vision generally do not have significant impairments in basic activities of daily living (ADL) such as self-care because, over time, they have learned habits and routines that come naturally and do not require the use of intensive visual skills. Rather, low vision has an impact on instrumental activities of daily living (IADL), the tasks involved in managing home, work, leisure and family care. Many older adults enter long-term care because of physical disabilities that impede their ability to complete self-care. However, otherwise healthy older adults with low vision tend to lose their ability to age in place due to difficulties with IADL. They may misread a medication label or leave their oven on because they cannot see the dial. Research supports these claims, with participants reporting independence in ADL but significant disability in leisure, work, social and mobility activities

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for GNB isolation were polypharmacy (P = .03) and history of IHD (P = .01). CONCLUSIONMore than one-third of the LTC residents sampled had GNB isolated from their oropharynx. This rate was three times as high as in community-dwelling older persons of similar age and sex. These findings are in keeping with those previously published. 7,8 Although LTC residents had a higher incidence of LRTI in the year before sampling and received more antibiotics, no association was found between these factors and the isolation of GNB. Novel findings from this study include the association between polypharmacy, IHD, and GNB isolation, which was independent of age and residence in a LTC facility. Recent antibiotic use was not identified as a risk factor, but detailed analysis of the other medication classes associated with GNB isolation was beyond the scope of this study. Underlying disease and xerostomia-inducing medications are associated with low salivary flow, 9 which has in turn been linked with oropharyngeal bacterial colonization. 10 One explanation for this is that less saliva leads to smaller quantities of buccal-cell fibronectin. An inverse relationship between fibronectin and adherence of GNB to buccal mucosal cells has been demonstrated. 11 Greater attention to oral hygiene and polypharmacy is required, particularly in residents of LTC facilities who are dependent on others for oral care, to reduce the risk of GNB colonization.