A population study of correlates of social participation in older adults with age-related vision loss

2016 ◽  
Vol 31 (1) ◽  
pp. 115-125 ◽  
Author(s):  
Verena R Cimarolli ◽  
Kathrin Boerner ◽  
Joann P Reinhardt ◽  
Amy Horowitz ◽  
Hans-Werner Wahl ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Environmental Factors ◽  
Social Participation ◽  
Vision Loss ◽  
Age Related Macular Degeneration ◽  
Social Contacts ◽  
Income Adequacy ◽  
Age Related ◽  
Social Leisure

Objective: To examine personal characteristics, disease-related impairment variables, activity limitations, and environmental factors as correlates of social participation in older adults with vision loss guided by the World Health Organization’s International Classification of Functioning, Disability and Health Model. Design: Baseline data of a larger longitudinal study. Setting: Community-based vision rehabilitation agency. Subjects: A total of 364 older adults with significant vision impairment due to age-related macular degeneration. Main Measures: In-person interviews assessing social participation (i.e. frequency of social support contacts, social/leisure challenges faced due to vision loss, and of social support provided to others) and hypothesized correlates (e.g. visual acuity test, Functional Vision Screening Questionnaire, ratings of attachment to house and neighborhood, environmental modifications in home). Results: Regression analyses showed that indicators of physical, social, and mental functioning (e.g. better visual function, fewer difficulties with instrumental activities of daily living, fewer depressive symptoms) were positively related to social participation indicators (greater social contacts, less challenges in social/leisure domains, and providing more support to others). Environmental factors also emerged as independent correlates of social participation indicators when functional variables were controlled. That is, participants reporting higher attachment to their neighborhood and better income adequacy reported having more social contacts; and those implementing more environmental strategies were more likely to report greater challenges in social and leisure domains. Better income adequacy and living with more people were related to providing more social support to others. Conclusion: Environmental variables may play a role in the social participation of older adults with age-related macular degeneration.

Challenges faced by older adults with vision loss: a qualitative study with implications for rehabilitation

2011 ◽  
Vol 26 (8) ◽  
pp. 748-757 ◽  
Author(s):  
Verena R Cimarolli ◽  
Kathrin Boerner ◽  
Mark Brennan-Ing ◽  
Joann P Reinhardt ◽  
Amy Horowitz
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Vision Loss ◽  
Age Related Macular Degeneration ◽  
Functional Domain ◽  
Social Challenges ◽  
Age Related ◽  
Vision Rehabilitation ◽  
Almost All ◽  
Over Time

Objective: To provide an in-depth assessment of challenges faced by older adults with recent vision loss and to determine changes in the nature of these challenges over time for the purpose of informing the design of vision rehabilitation services. Design: Longitudinal, qualitative study with three time points. Setting: Vision rehabilitation agency. Subjects: Three hundred and sixty-four older adults aged 65 with significant vision impairment due to age-related macular degeneration. Interventions: In-person interviews conducted at baseline, one year and two years and coded using a qualitative analytical approach. Main measures: Open-ended questions assessing challenges faced due to vision loss in functional, social and psychological life domains. Results: Almost all participants reported a wide variety of challenges across all three domains with the most variety in the functional domain. Over a two-year period, functional challenges (e.g. using transportation) increased, social challenges (e.g. recognizing people) remained stable, and psychological challenges (e.g. negative affect) decreased overall. Conclusions: Although functional challenges are predominant, social and psychological challenges are quite common and need to be addressed in vision rehabilitation. Rehabilitation planning should also consider that vision-related challenges can change over time.

Setting research priorities in age-related vision loss: The first step in a critical participatory action research approach

2021 ◽  
pp. 026461962098421
Author(s):  
Colleen McGrath
Keyword(s):  
Older Adults ◽  
Action Research ◽  
Environmental Factors ◽  
Participatory Action Research ◽  
Vision Loss ◽  
Community Support ◽  
Participatory Action ◽  
Activity Engagement ◽  
Age Related ◽  
Critical Participatory Action Research

There are no known examples of studies utilizing a critical participatory action research (CPAR) approach with older adults aging with vision loss, to better understand how environmental factors impact activity engagement. As such, the aim of this article was to share the process of initiating a CPAR approach with older adults with age-related vision loss to identify a set of research and/or rehabilitation priorities related to the influence of physical, social, cultural, political, and institutional environmental factors on activity engagement. This study utilized a CPAR approach. Eight older adults (aged 65 years of age and older) with a diagnosis of age-related vision loss (including macular degeneration, glaucoma, and/or diabetic retinopathy) took part in three half-day meetings as well as a one-on-one interview over a period of 2 months. Through a series of facilitated group discussions, the older adults identified research and/or rehabilitation priorities related to how environmental influences support or limit the participation of older adults with age-related vision loss (ARVL) in everyday activities. Three research and/or rehabilitation priorities were identified including (1) community mobility; (2) assistive technology; and (3) community support and services. For each priority, the older adults, along with the researchers, answered four key questions including (1) What do we need to know more about? (i.e., research question); (2) How could we learn more about this? (i.e., proposed methods of data collection); (3) Who would we need to involve as key stakeholders? (i.e., participants); and (4) What would change look like? (i.e., action potential). This study shared the process of initiating a CPAR process with eight older adults with ARVL to identify research and/or rehabilitation priorities. By doing so, this study will help to provide direction for future ARVL research and rehabilitation that is grounded, methodologically, in a CPAR approach.

The Difference that Age Makes: Cultural Factors that Shape Older Adults’ Responses to Age-Related Macular Degeneration

2008 ◽  
Vol 102 (10) ◽  
pp. 581-590 ◽  
Author(s):  
Marja Mogk
Keyword(s):  
Older Adults ◽  
Macular Degeneration ◽  
Vision Loss ◽  
Cultural Factors ◽  
Age Related Macular Degeneration ◽  
Sociocultural Perspective ◽  
Visual Rehabilitation ◽  
Age Related ◽  
Perceptions Of Aging ◽  
The Difference

This article suggests that approaching vision loss from age-related macular degeneration from a sociocultural perspective, specifically considering perceptions of aging, blindness, disability, and generational viewpoints and norms, may be critical to understanding older adults’ responses to vision loss and visual rehabilitation.

The environmental factors that influence technology adoption for older adults with age-related vision loss

2018 ◽  
Vol 82 (8) ◽  
pp. 493-501 ◽  
Author(s):  
Colleen McGrath ◽  
Ann Marie Corrado
Keyword(s):  
Older Adults ◽  
Technology Adoption ◽  
Environmental Factors ◽  
Vision Loss ◽  
Low Vision ◽  
Assistive Device ◽  
Holistic View ◽  
Technology Industry ◽  
Age Related ◽  
Assessment Activity

IntroductionWith the increasing proportion of older adults aging with vision loss, low-vision assistive devices can help to support occupational engagement; however, such devices are grossly underused among this population. The overarching purpose of this project was to examine the environmental factors that influence technology adoption for older adults with age-related vision loss.MethodsA one-day workshop, which utilized a variety of hands-on methods including Show & Tell, Technology Interaction, and an “App” Assessment activity, was conducted. A total of 19 participants attended the workshop, including 10 older adults with age-related vision loss, six caregivers, one healthcare provider, and two technology industry professionals.ResultsA total of four themes emerged, including: (1) making life harder; (2) relying on support networks; (3) factoring in the pragmatics; and (4) not me, not yet. These themes illustrate the various ways that environmental factors, including physical, social, cultural, and institutional/political factors, influence decision-making regarding technology adoption by older adults with age-related vision loss.ConclusionThis paper demonstrates several environmental factors that influence low-vision assistive device adoption among older adults with age-related vision loss. With their holistic view of clients, including an appreciation for environmental influences, occupational therapists are well positioned to help identify those environmental barriers limiting low-vision assistive device adoption and use.

scholarly journals Role of amyloid β-peptide in the pathogenesis of age-related macular degeneration

2021 ◽  
Vol 6 (1) ◽  
pp. e000774
Author(s):  
Minwei Wang ◽  
Shiqi Su ◽  
Shaoyun Jiang ◽  
Xinghuai Sun ◽  
Jiantao Wang
Keyword(s):  
Mitochondrial Dysfunction ◽  
Macular Degeneration ◽  
Vision Loss ◽  
Cell Structure ◽  
Pigment Epithelium ◽  
Retinal Pigment ◽  
Amyloid Β ◽  
Age Related Macular Degeneration ◽  
Amyloid Β Peptide ◽  
Age Related

Age-related macular degeneration (AMD) is the most common eye disease in elderly patients, which could lead to irreversible vision loss and blindness. Increasing evidence indicates that amyloid β-peptide (Aβ) might be associated with the pathogenesis of AMD. In this review, we would like to summarise the current findings in this field. The literature search was done from 1995 to Feb, 2021 with following keywords, ‘Amyloid β-peptide and age-related macular degeneration’, ‘Inflammation and age-related macular degeneration’, ‘Angiogenesis and age-related macular degeneration’, ‘Actin cytoskeleton and amyloid β-peptide’, ‘Mitochondrial dysfunction and amyloid β-peptide’, ‘Ribosomal dysregulation and amyloid β-peptide’ using search engines Pubmed, Google Scholar and Web of Science. Aβ congregates in subretinal drusen of patients with AMD and participates in the pathogenesis of AMD through enhancing inflammatory activity, inducing mitochondrial dysfunction, altering ribosomal function, regulating the lysosomal pathway, affecting RNA splicing, modulating angiogenesis and modifying cell structure in AMD. The methods targeting Aβ are shown to inhibit inflammatory signalling pathway and restore the function of retinal pigment epithelium cells and photoreceptor cells in the subretinal region. Targeting Aβ may provide a novel therapeutic strategy for AMD.

A Structured Support Group for Midlife and Older Adults with Vision Loss

1994 ◽  
Vol 88 (2) ◽  
pp. 152-156 ◽  
Author(s):  
K.J. McCulloh ◽  
I. Crawford ◽  
J.D. Resnick
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Support Groups ◽  
Support Group ◽  
Visually Impaired ◽  
Vision Loss

This article describes an eight-week structured social support group for midlife and older adults who are adventitiously visually impaired. The group objectives, topics covered, and issues encountered are presented, along with recommendations for developing future support groups for this population.

scholarly journals Mingjing granule, a traditional Chinese medicine in the treatment of neovascular age-related macular degeneration: study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yamin Li ◽  
Lina Liang ◽  
Torkel Snellingen ◽  
Kai Xu ◽  
Yun Gao ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Macular Degeneration ◽  
Vision Loss ◽  
Age Related Macular Degeneration ◽  
Case Report Form ◽  
Link Type ◽  
Anti Vegf ◽  
Age Related ◽  
Function Test

Abstract Background Neovascular age-related macular degeneration (nAMD) is the most common cause of irreversible vision loss and blindness among the older people aged 50 and over. Although anti-vascular endothelial growth factor (anti-VEGF) therapies have resulted in improving patient outcomes, there are limitations associated with these treatments. In China, traditional Chinese medicine (TCM) has been used to treat eye diseases for more than 2000 years. Previous studies have shown that TCM may be beneficial for nAMD patients. However, explicit evidence has not been obtained. The purpose of the present trial is to examine the efficacy and safety of the Mingjing granule, a compound Chinese herbal medicine, for nAMD patients. Methods/design This is a double-blind, placebo-controlled, randomized trial of Mingjing granule as an add-on to intravitreous ranibizumab for nAMD. One hundred eighty nAMD patients from six hospitals in China will be enrolled according to the inclusion and exclusion criteria and randomly allocated into two groups, 90 in each. All participants will receive a 24-week treatment and then be followed up for another 24 weeks. The primary outcome is the mean change of best-corrected visual acuity at week 24 and 48 as compared to the baseline. The secondary outcomes include mean change in central retinal thickness, area of retinal hemorrhage and exudation, and TCM syndrome score, mean number of intravitreal ranibizumab injection, and total cost of the treatment. Indexes of safety include blood regular test, urine regular test, liver function test, renal function test, and electrocardiogram from baseline to weeks 24 and 48. Qualitative control and some standard operating processes will be formed throughout the trial. Any ocular or systemic adverse events will be treated suitably, and related data will be recorded accurately and completely in the case report form. Discussion Based on previous empirical and animal laboratory studies, this study will address the question of whether Mingjing granule could contribute to improving efficacy, safety, and efficiency with need for fewer intravitreal injections of anti-VEGF, improving compliance and visual outcomes in the management of persons with nAMD. Trial registration Chinese Clinical Trial Registry (http://www.chictr.org.cn), ChiCTR2000035990. Registered on 21 August 2020.

scholarly journals One-year outcomes of fixed-dosing Aflibercept therapy for pre treated and naive polypoidal choroidal vasculopathy patient

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hun Gu Choo ◽  
Jin Hae Lee ◽  
Hyun Sub Oh ◽  
Soon Hyun Kim ◽  
Yong Sung You ◽  
...  
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Vision Loss ◽  
Case Series ◽  
Age Related Macular Degeneration ◽  
Research Information ◽  
Age Related ◽  
Case Series Study ◽  
Treatment Naïve ◽  
One Year ◽  
Choroidal Vasculopathy

Abstract Background Polypoidal choroidal vasculopathy (PCV) is a type of age-related macular degeneration that can cause permanent vision loss. The purpose of this paper was to report the one-year outcomes of fixed-dosing aflibercept therapy for the treatment of PCV. Methods This was a prospective, single-arm, interventional case series study of 25 PCV patients; 12 pre-treated and 13 treatment-naïve patients. The patients were treated and monitored for 12 months. Each patient was administered with an aflibercept (2.0 mg) injection every month for the first 3 months (the loading phase), and thereafter, once every 2 months. At every follow-up visit, best-corrected visual acuity (BCVA) test, fundus examination, and optical coherence tomography for measuring the central subfield macular thickness (CSMT) were performed. Fluorescein and indocyanine green angiography were conducted at baseline and at 4 and 12 months. Results After 12 months of aflibercept therapy, the mean BCVA of the patients significantly improved from 65.48 letters at baseline to 69.91 letters (p=0.001), and the CSMT significantly decreased from 406.92 um at baseline to 276.12 um (p< 0.001). Additionally, ten patients (40%) showed complete polyp regression. The treatment-naïve patients showed a statistically significant improvement in BCVA from 66.58 letters at baseline to 76.36 letters at 12 months, and a significant decrease in CSMT, from 462 to 243 um. In the pre-treated group, there was no change in BCVA (64.46 letters), and the decrease in CSMT from 356.08 to 303.69 um was not statistically significant. Conclusions The fixed-dosing aflibercept regimen is effective for treating patients with PCV and is more effective in treatment-naïve patients than in pre-treated patients. Trial registration Clinical Research Information Service (CRiS), Republic of Korea. Identifer: KCT0005798, Registered: Jan 20, 2021. Retrospectively registered, URL: https://cris.nih.go.kr/cris/en/search/search_result_st01.jsp?seq=18546

scholarly journals A Systematic Review of Carotenoids in the Management of Diabetic Retinopathy

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2441
Author(s):  
Drake W. Lem ◽  
Dennis L. Gierhart ◽  
Pinakin Gunvant Davey
Keyword(s):  
Diabetic Retinopathy ◽  
Vision Loss ◽  
Therapeutic Potential ◽  
Microvascular Disease ◽  
Age Related Macular Degeneration ◽  
Cell Degeneration ◽  
Neuroprotective Effects ◽  
Age Related ◽  
Induced Changes ◽  
Dietary Carotenoid

Diabetic retinopathy, which was primarily regarded as a microvascular disease, is the leading cause of irreversible blindness worldwide. With obesity at epidemic proportions, diabetes-related ocular problems are exponentially increasing in the developed world. Oxidative stress due to hyperglycemic states and its associated inflammation is one of the pathological mechanisms which leads to depletion of endogenous antioxidants in retina in a diabetic patient. This contributes to a cascade of events that finally leads to retinal neurodegeneration and irreversible vision loss. The xanthophylls lutein and zeaxanthin are known to promote retinal health, improve visual function in retinal diseases such as age-related macular degeneration that has oxidative damage central in its etiopathogenesis. Thus, it can be hypothesized that dietary supplements with xanthophylls that are potent antioxidants may regenerate the compromised antioxidant capacity as a consequence of the diabetic state, therefore ultimately promoting retinal health and visual improvement. We performed a comprehensive literature review of the National Library of Medicine and Web of Science databases, resulting in 341 publications meeting search criteria, of which, 18 were found eligible for inclusion in this review. Lutein and zeaxanthin demonstrated significant protection against capillary cell degeneration and hyperglycemia-induced changes in retinal vasculature. Observational studies indicate that depletion of xanthophyll carotenoids in the macula may represent a novel feature of DR, specifically in patients with type 2 or poorly managed type 1 diabetes. Meanwhile, early interventional trials with dietary carotenoid supplementation show promise in improving their levels in serum and macular pigments concomitant with benefits in visual performance. These findings provide a strong molecular basis and a line of evidence that suggests carotenoid vitamin therapy may offer enhanced neuroprotective effects with therapeutic potential to function as an adjunct nutraceutical strategy for management of diabetic retinopathy.

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