Effects of Age-Related Macular Degeneration and Ambient Light on Curb Negotiation

Alexander, M. Scott; Lajoie, Kim; Neima, David; Strath, Robert A.; Robinovitch, Stephen N.; Marigold, Daniel S.

doi:10.1097/opx.0000000000000286

Cited by 21 publications

(24 citation statements)

References 40 publications

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“…DIF analysis comparing glaucoma patients with and without AMD demonstrated that patients with glaucoma and AMD had greater difficulty walking on uneven ground, using stairs and judging distances of foot to step/curb than those without AMD. These findings support work by Alexander et al, who demonstrated that patients with AMD had increased difficulty when negotiating a curb and poorer gait precision in lower ambient light levels compared with normal subjects. As both AMD and visual field loss from glaucoma increase the risk of falling among older adults, it is understandable that the combination of both conditions leads to a heightened awareness of hazardous gait.…”

Section: Discussionsupporting

confidence: 90%

Impact of age‐related macular degeneration in patients with glaucoma: understanding the patients' perspective

Skalicky

Fenwick

Martin

et al. 2016

Clinical Exper Ophthalmology

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Section: Discussionsupporting

confidence: 90%

Impact of age‐related macular degeneration in patients with glaucoma: understanding the patients' perspective

Skalicky

Fenwick

Martin

et al. 2016

Clinical Exper Ophthalmology

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“…People with AMD walk more cautiously, make more gait modifications while walking on altered surfaces47 and have difficulty stepping on low contrast targets in dim light and during dark adaptation 49. AMD affects navigating paths under low lighting51 and curb navigation particularly during dim lighting and dark adaptation 50. AMD patients performed worse on an obstacle course in dim lighting compared to well-lit conditions 52…”

Section: Resultsmentioning

confidence: 99%

How does age-related macular degeneration affect real-world visual ability and quality of life? A systematic review

et al. 2016

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ObjectivesTo review systematically the evidence of age-related macular degeneration (AMD) affecting real-world visual ability and quality of life (QoL). To explore trends in specific topics within this body of the literature.DesignSystematic review.MethodsA systematic literature search was carried out using MEDLINE, EMBASE, CINAHL, PsycINFO, PsychARTICLES and Health and Psychosocial Instruments for articles published up to January 2015 for studies including people diagnosed with AMD, assessing real-world visual ability or QoL as an outcome. Two researchers screened studies for eligibility. Details of eligible studies including study design, characteristics of study population and outcomes measured were recorded in a data extraction table. All included studies underwent quality appraisal using the Mixed Methods Appraisal Tool 2011 Version (MMAT).ResultsFrom 5284 studies, 123 were eligible for inclusion. A range of approaches were identified, including performance-based methods, quantitative and qualitative patient-reported outcome measures (PROMs). AMD negatively affects tasks including mobility, face recognition, perception of scenes, computer use, meal preparation, shopping, cleaning, watching TV, reading, driving and, in some cases, self-care. There is evidence for higher rates of depression among people with AMD than among community dwelling elderly. A number of adaptation strategies have been associated with AMD of varying duration. Much of the research fails to report the type of AMD studied (59% of included studies) or the duration of disease in participants (74%). Of those that do report type studied, the breakdown is as follows: wet AMD 20%, dry AMD 4% and both types 17%.ConclusionsThere are many publications highlighting the negative effects of AMD in various domains of life. Future research should focus on delivering some of this research knowledge into patient management and clinical trials and differentiating between the types of AMD.

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“…Visual information is a crucial sensory input that facilitates safe walking. A number of studies have shown associations between diminished or abnormal visual input and decrements in walking performance, including during control of steady state walking (Helbostad et al, 2009 ; Swenor et al, 2014 ) and during more complex tasks like obstacle crossing and curb negotiation (Alexander et al, 2014a , b ; Novak and Deshpande, 2014 ). This may be due in part to impaired automaticity of walking.…”

Section: Mechanistic Factors That Influence Automaticitymentioning

confidence: 99%

Automaticity of walking: functional significance, mechanisms, measurement and rehabilitation strategies

Clark

2015

Front. Hum. Neurosci.

324

276

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Automaticity is a hallmark feature of walking in adults who are healthy and well-functioning. In the context of walking, “automaticity” refers to the ability of the nervous system to successfully control typical steady state walking with minimal use of attention-demanding executive control resources. Converging lines of evidence indicate that walking deficits and disorders are characterized in part by a shift in the locomotor control strategy from healthy automaticity to compensatory executive control. This is potentially detrimental to walking performance, as an executive control strategy is not optimized for locomotor control. Furthermore, it places excessive demands on a limited pool of executive reserves. The result is compromised ability to perform basic and complex walking tasks and heightened risk for adverse mobility outcomes including falls. Strategies for rehabilitation of automaticity are not well defined, which is due to both a lack of systematic research into the causes of impaired automaticity and to a lack of robust neurophysiological assessments by which to gauge automaticity. These gaps in knowledge are concerning given the serious functional implications of compromised automaticity. Therefore, the objective of this article is to advance the science of automaticity of walking by consolidating evidence and identifying gaps in knowledge regarding: (a) functional significance of automaticity; (b) neurophysiology of automaticity; (c) measurement of automaticity; (d) mechanistic factors that compromise automaticity; and (e) strategies for rehabilitation of automaticity.

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Effects of Age-Related Macular Degeneration and Ambient Light on Curb Negotiation

Cited by 21 publications

References 40 publications

Impact of age‐related macular degeneration in patients with glaucoma: understanding the patients' perspective

Impact of age‐related macular degeneration in patients with glaucoma: understanding the patients' perspective

How does age-related macular degeneration affect real-world visual ability and quality of life? A systematic review

Automaticity of walking: functional significance, mechanisms, measurement and rehabilitation strategies

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