Association of Social Support Network Size With Receipt of Cataract Surgery in Older Adults

Choi, Hwajung; Woodward, Maria A.; Ehrlich, Joshua R.

doi:10.1001/jamaophthalmol.2018.0244

Cited by 16 publications

(8 citation statements)

References 14 publications

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“…The NHATS is a nationally representative survey that is administered annually to a cohort of US Medicare beneficiaries 65 years and older and has provided important insights on vision and aging. [5][6][7]21 The baseline NHATS sample was recruited in 2011, and the sample was replenished in 2015. At the time of recruitment, all participants were living in settings other than nursing homes.…”

Section: Study Samplementioning

confidence: 99%

Association of Co-occurring Dementia and Self-reported Visual Impairment With Activity Limitations in Older Adults

et al. 2020

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IMPORTANCEThe number of older adults with visual impairment (VI) and dementia is projected to increase in the US because of the aging of the population. Dementia and VI commonly co-occur and are each independently associated with disability. To care for an aging population, it may be important to characterize the association of coexisting dementia and self-reported VI on daily functioning. OBJECTIVE To evaluate the association of co-occurring dementia and self-reported VI on daily functioning. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional analysis of a nationally representative cohort study used data from the National Health and Aging Trends Study (NHATS), an annual study of US adults 65 years and older. Participants in the 2015 survey with complete data on outcomes, associated factors, and covariates were included in this study. Data analysis took place from January 2019 to November 2019. MAIN OUTCOMES AND MEASURESMultivariable Poisson regression was used to model the independent associations and interaction of dementia and self-reported VI status on 3 functional activity scales (self-care, mobility, and household activities). Marginal predicted proportions were calculated. Analyses were adjusted for sociodemographic and medical factors and accounted for the complex survey design.RESULTS A total of 7124 participants were included. The weighted proportion of female respondents was 55.3% (95% CI, 54.0%-56.6%), and 56.1% (95% CI, 54.1%-58.1%) were between 65 and 74 years old. Self-reported VI was present in 8.6% (95% CI, 7.8%-9.3%) of participants, while 8.3% (95% CI, 7.8%-8.9%) had possible dementia and 6.3% (95% CI, 5.7%-6.9%) had probable dementia. Self-reported VI was associated with an expected decrease in mobility score of 14.7% (functional scale scores: no VI, 10.82 vs VI, 9.23), self-care score of 9.5% (no VI, 14.54 vs VI, 13.16), and household activity score of 15.2% (no VI, 18.23 vs VI, 15.45), while probable dementia was associated with expected decreases of 27.8% (no dementia, 10.82 vs probable dementia, 7.81), 22.9% (no dementia, 14.54 vs probable dementia, 11.20), and 34.7% (no dementia, 18.23 vs probable dementia, 11.90), respectively. Among those with probable dementia and self-reported VI, there was an expected decrease in mobility score of 50.1% (functional ability scores: no VI and no dementia, 10.82 vs VI and probable dementia, 5.40), self-care score of 42.4% (no VI and no dementia, 14.54 vs VI and probable dementia, 8.38), and household activity score of 52.4% (no VI and no dementia, 18.23 vs VI and probable dementia, 8.68), suggesting that respondents with co-occurring dementia and self-reported VI had lower functional activity scores than would be associated with the independent contributions of these conditions.CONCLUSIONS AND RELEVANCE Older adults with both dementia and self-reported VI may be at high risk for disability, and their co-occurrence may potentiate this risk. These findings suggest that the growing population of older adults with both visual impairment and dementia ma...

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Section: Study Samplementioning

confidence: 99%

Association of Co-occurring Dementia and Self-reported Visual Impairment With Activity Limitations in Older Adults

et al. 2020

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“…A parsimonious set of demographic, socioeconomic, psychosocial, and illness factors that were known to be associated with both VI and well-being (3,4,9,23,24) were included as covariates. Demographic factors included age groups in 5-year intervals, sex, and race/ethnicity.…”

Section: Covariatesmentioning

confidence: 99%

Self-reported Vision Impairment and Subjective Well-being in Older Adults: A Longitudinal Mediation Analysis

Xiang

Freedman

Shah

et al. 2019

The Journals of Gerontology: Series A

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Abstract Background Vision impairment (VI) in older adults is associated with declines in well-being. However, the pathways through which poor vision leads to declines in well-being have not been well-described. The purpose of this study was to determine whether activity limitations and social participation restrictions mediate the impact of self-reported VI on subjective well-being. Methods The National Health and Aging Trends Study (NHATS) is a nationally representative longitudinal study of Medicare beneficiaries 65 and older that includes detailed measures of the disablement process. A longitudinal mediation model was conceptualized linking self-reported VI and subjective well-being. Structural equation modeling was used to test the mediating effects of activity limitations and social participation restrictions while adjusting for relevant covariates. Results The final sample included 5,431 respondents. At baseline, 8.0% of Medicare beneficiaries had self-reported VI. Subjective well-being scores were significantly lower among respondents with self-reported VI (15.7; 95% confidence interval [CI]: 15.2, 16.2) compared with those without VI (17.6; 95% CI: 17.5, 17.7). Self-reported VI had a significant indirect effect on subjective well-being through limiting mobility (β = −0.04; 95% CI: −0.07, −0.03) and household activities (β = −0.05; 95% CI: −0.08, −0.03), but not self-care limitations (β = 0.0; 95% CI = 0.0, 0.0) or participation restrictions (β = 0.0; 95% CI = −0.01, 0.00). Total indirect effects from all mediation paths accounted for 42% of the effect of VI on well-being. Conclusions Mobility and household activity limitations are significant mediators that explain a considerable portion of the impact of poor vision on well-being. Interventions to promote successful accommodation may result in greater overall well-being for older adults with poor vision.

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“…(5) Of note, it has been reported that older adults with dementia are less likely than their peers to undergo cataract surgery. (6) To date, there have been relatively few publications on cataract surgery in patients older than 90 years. (1,2,5,7) Reports on outcome in these very elderly people are conflicting as to whether older age, in itself, is a significant predictor of worse visual acuity outcome or not.…”

Section: Introductionmentioning

confidence: 99%

The Royal College of Ophthalmologists’ National Ophthalmology Database Study of cataract surgery. Report 5: Clinical outcome and risk factors for posterior capsule rupture and visual acuity loss following cataract surgery in patients aged 90 years and older

Theodoropoulou

Grzeda

Donachie

et al. 2019

Eye

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The Royal College of Ophthalmologists' National Ophthalmology Database Study of cataract surgery. Report 5: Clinical outcome and risk factors for posterior capsule rupture and visual acuity loss following cataract surgery in patients aged 90 years and older. Abstract BackgroundOlder age is commonly associated with an increased risk of surgical complications and comparatively poor outcomes. PurposeTo report cataract surgery outcomes and risk indicators for patients aged 90 years and older. MethodsData collected as part of routine cataract care in 34 centres contributing to the United Kingdom Royal College of Ophthalmologists' National Ophthalmology Database (NOD) were analysed. Very elderly people undergoing cataract surgery were profiled in terms of demographics, pre--and postoperative best--measured visual acuity (VA), ocular co--morbidities, intraoperative posterior capsule rupture (PCR) or vitreous loss or both, and risk indicators for operative PCR and adverse VA outcome. Results 25,856 cataract operations in 19,166 people of 90 years or older between 2000 and 2014 arereported. Preoperative VA was available for 82.4% eyes, being 0.30 LogMAR or better in 21.5%.Postoperative VA was available for 61.8% eyes, being 0.30 LogMAR or better in 74.4%. For those without ocular co--morbidity, postoperative VA was 0.30 LogMAR or better in 84.7%. Various co-morbidities were present in 49% and contributed to an adverse VA outcome. PCR data was available for all operations and occurred in 2.7%. Significant risk indicators for PCR included pseudoexfoliation/phakodonesis, mature cataract, smaller pupil and worse preoperative VA. Conclusions:Slightly poorer cataract surgery outcome results were noted in patients of 90 years or older, more so in patients with ocular co--morbidity which was highly prevalent. However, surgeons should not be

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Association of Social Support Network Size With Receipt of Cataract Surgery in Older Adults

Cited by 16 publications

References 14 publications

Association of Co-occurring Dementia and Self-reported Visual Impairment With Activity Limitations in Older Adults

Association of Co-occurring Dementia and Self-reported Visual Impairment With Activity Limitations in Older Adults

Self-reported Vision Impairment and Subjective Well-being in Older Adults: A Longitudinal Mediation Analysis

The Royal College of Ophthalmologists’ National Ophthalmology Database Study of cataract surgery. Report 5: Clinical outcome and risk factors for posterior capsule rupture and visual acuity loss following cataract surgery in patients aged 90 years and older

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