Poor Vision and Self-Reported Functional Difficulties among Recently Hospitalized Individuals in the United States

ABSTRACT

Purpose: Many hospitalized adults may have limited vision and as a result be at increased risk of worse functional outcomes. Here, we determine the prevalence of poor vision among recently hospitalized United States adults. Additionally, we evaluate the impact of objective vision defects on reading difficulty and external mobility outcomes (difficulty with falls and going down steps).

Methods: Our cross-sectional study included 1,347 adult Americans aged 50 years and older, all recently hospitalized, participating in the 2001–2008 National Health and Nutrition Examination Survey (NHANES). Self-reported difficulty with reading and going down steps/stairs/curbs data were collected for all participants, while data on self-reported falling difficulty were only available for the 2001–2004 NHANES (n=631). Presenting near and distance visual acuity (VA) were measured, with poor vision defined as VA worse than 20/40.

Results: Poor near and distance vision were present in 17.4% and 9.8% of individuals, respectively. Multivariable analyses showed that the odds of reading difficulty were greater with worse VA (odds ratio, OR, 1.9 per 0.3 logMAR increment in near VA, 95% confidence interval, CI, 1.6–2.4, P<0.01), as were the odds of difficulty going down steps/stairs/curbs (OR 2.4 per 0.3 logMAR increment in distance VA, 95% CI 1.9–3.1, P<0.01) and odds of falling difficulty (OR 1.6 per 0.3 logMAR increment in distance VA, 95% CI 1.1–2.4, P=0.04).

Conclusion: About 1 in 10 and 1 in 6 recently hospitalized older Americans had poor distance and near vision, respectively. Many of these individuals may experience trouble reading hospital documents and ambulating, and may be at increased risk of falls.

KEYWORDS:

• Epidemiology
• falls
• low vision
• public
• health
• visual function

Acknowledgments

This work was supported by NIH grant EY018595 & EY022976 and the Research to Prevent Blindness. The NHANES 2001-8 protocols were reviewed and approved by the National Center for Health Statistics research ethics review board. Informed consent was obtained from all participants. The research adhered to the tenets of the Declaration of Helsinki. None of the authors have any proprietary interests or conflicts of interest related to this submission. Both Dr. Jeffrey Willis and Dr. Pradeep Ramulu had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.