Using Objective Vision Measures to Explore the Association of Vision Impairment With Cognition Among Older Adults in the United States

Almidani, Louay; Varadaraj, Varshini; Mihailović, Aleksandra; Ramulu, Pradeep Y.

doi:10.1016/j.ajo.2023.05.020

Cited by 6 publications

(3 citation statements)

References 40 publications

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“…Distance and near VI were defined as greater than 0.30 logMAR based on the US American Academy of Ophthalmology definitions (Snellen equivalent worse than 20/40), and CS impairment (CSI) was defined as less than 1.55 logCS . Any VI was defined as VI in either distance or near VA or CS, as previously defined …”

Section: Methodsmentioning

confidence: 99%

“…21 Any VI was defined as VI in either distance or near VA or CS, as previously defined. 22 Other Variables Data on age (continuous), self-reported sex (male, female), self-reported race and ethnicity, living arrangement (alone), education (≤high school, some college/vocational, ≥college graduate), and income (<$22 000, $22 000-$40 000, $40 000-$75 000, >$75 000; income quartiles were based on the income distribution in the sample, and missing income data were filled in using multiple imputation values provided by the NHATS), and number of comorbidities (0-1, 2, 3, ≥4). Self-reported comorbid conditions including heart attack, heart disease, high blood pressure, arthritis, osteoporosis, diabetes, stroke, dementia/Alzheimer disease, and cancer were also collected.…”

Section: Key Pointsmentioning

confidence: 99%

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Digital Technology Use Among Older Adults With Vision Impairment

Thomas,

Almidani,

Swenor

et al. 2024

JAMA Ophthalmol

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ImportanceTelehealth has the potential to improve health for older adults, but many access disparities exist, including for those with vision impairment (VI).ObjectiveTo examine the associations between VI and digital technology access measures in US older adults.Design, Setting, and ParticipantsThis was a cross-sectional study that included Medicare beneficiaries 65 years and older. Beneficiary data were obtained from the National Health and Aging Trends Study (NHATS) 2021; data collection was conducted from June 2020 through January 2021. Data were analyzed September 2023.ExposureVI, measured on categorical (distance and near VI [&gt;0.30 logMAR], contrast sensitivity impairment [CSI; &lt;1.55 logCS], and any VI [distance VI, near VI, or CSI]), and continuous (distance and near acuity [logMAR] and contrast sensitivity [logCS]) scales.Main OutcomesSelf-reported outcomes of digital technology access from the technological environment component of the NHATS.ResultsOf the 2822 Medicare beneficiaries (mean [SD] age, 78.5 [5.6] years; 1605 female [54.7%]) included in this study, patients self-identified with the following race and ethnicity categories (weighted percentages): 575 non-Hispanic Black (8.0%), 132 Hispanic (7.0%), 2019 non-Hispanic White (81.7%), and 63 non-Hispanic other race (3.4%), which included American Indian, Alaska Native, Asian, multiracial, Native Hawaiian, Pacific Islander, or other specified race. A total of 1077 of 2822 patients (32.3%) had any VI. In multivariable logistic regression models, older adults with any VI had lower odds of having or knowing how to use a cellphone (odds ratio [OR], 0.58; 95% CI, 0.38-0.88), computer (OR, 0.61; 95% CI, 0.47-0.79), or tablet (OR, 0.68, 95% CI = 0.54-0.85) than peers without VI. In other models, near VI was associated with lower odds of having and knowing how to use a phone (OR, 0.56; 95% CI, 0.36-0.87), computer (OR, 0.57; 95% CI, 0.44-0.75), or tablet (OR, 0.65; 95% CI, 0.52-0.81) compared with no near VI. CSI was associated with lower odds of having and knowing how to use a phone (OR, 0.66; 95% CI, 0.45-0.99) or computer (OR, 0.72; 95% CI, 0.55-0.93) compared with no CSI. Distance VI was only associated with lower odds of having and knowing how to use a cellphone (OR, 0.63; 95% CI, 0.41-0.95). Any VI and individual categorical VI measures were not associated with other outcomes of digital health– and nonhealth-related experiences. Similar associations were noted when vision was examined on a continuous scale. However, worse distance acuity (per 0.1 logMAR) was associated with being less likely to visit with family or friends on a video call (OR, 0.91; 95% CI, 0.84-0.98) and to order or refill prescriptions online (OR, 0.90; 95% CI, 0.83-0.97).Conclusions and RelevanceResults suggest that older US adults with VI were less likely to have access to digital technology than peers without VI, although no differences were noted in the report of digital health– and nonhealth-related activities. These findings highlight the potential for inequities that may arise in telehealth for older adults with VI and the necessity to develop strategies to improve accessibility of telemedicine for all.

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Section: Methodsmentioning

confidence: 99%

Section: Key Pointsmentioning

confidence: 99%

Digital Technology Use Among Older Adults With Vision Impairment

Thomas,

Almidani,

Swenor

et al. 2024

JAMA Ophthalmol

Self Cite

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“… 17 Any objective VI, defined as having VI in any measurement of distance VA, near VA, or CS, was taken as the primary exposure, as previously defined. 18 …”

Section: Methodsmentioning

confidence: 99%