Multimorbidity Patterns and the Disablement Process among Public Long-Term Care Insurance Claimants in the City of Yiwu (Zhejiang Province, China)

This study aimed to identify multimorbidity patterns and explore the disablement process by utilizing the model raised by Verbrugge and Jette as a theoretical framework. This cross-sectional study used public Long-term Care Insurance (LTCI) claimants’ assessment data of Yiwu city in Zhejiang Province, China, for 2604 individuals aged 60 years and older, from September through December 2018. Latent Class Analysis (LCA) was conducted using 10 common chronic conditions. Structural Equation Modeling was used to examine the disablement process. The latent classes of multimorbidity patterns were the “coronary atherosclerotic heart disease” class (19.0%), the “lower limb fractures” class (26.4%), and the “other diseases” class (54.6%). The structural model results show that coronary atherosclerotic heart disease had a significant influence on incontinence, but it was not statistically significant in predicting vision impairment and mobility impairment. Lower limb fractures had significant effects on vision impairment, incontinence, and mobility impairment. Vision impairment, incontinence, and mobility impairment had significant effects on physical activities of daily living (ADLs). Our findings suggest that different impairments exist from specific patterns of multimorbidity to physical ADL disability, which may provide insights for researchers and policy makers to develop tailored care and provide support for physically disabled older people.

Vision impairment and cognitive decline among older adults: a systematic review

ObjectivesThere has been increasing epidemiological research examining the association between vision impairment (VI) and cognitive impairment and how poor vision may be a modifiable risk factor for cognitive decline. The objective of this systematic review is to synthesise the published literature on the association of VI with cognitive decline, cognitive impairment or dementia, to aid the development of interventions and guide public policies pertaining to the relationship between vision and cognition.MethodsA literature search was performed with Embase, Medline and Cochrane library databases from inception to March 2020, and included abstracts and articles published in peer-reviewed journals in English. Our inclusion criteria included publications that contained subjective/objective measures of vision and cognition, or a diagnosis of VI, cognitive impairment or dementia. Longitudinal or cross-sectional studies with ≥100 participants aged >50 years were included. The search identified 11 805 articles whose abstracts underwent screening by three teams of study authors. Data abstraction and quality assessment using the Effective Public Health Practice Project Quality Assessment Tool were performed by one author (NN). 10% of the articles underwent abstraction and appraisal by a second author (LA/VV), results were compared between both and were in agreement.Results110 full-text articles were selected for data extraction, of which 53 were cross-sectional, 43 longitudinal and 14 were case–control studies. The mean age of participants was 73.0 years (range 50–93.1). Ninety-one (83%) of these studies reported that VI was associated with cognitive impairment.ConclusionOur systematic review indicates that a majority of studies examining the vision–cognition relationship report that VI is associated with more cognitive decline, cognitive impairment or dementia among older adults. This synthesis supports the need for additional research to understand the mechanisms underlying the association between VI and cognitive impairment and to test interventions that mitigate the cognitive consequences of VI.

“Talk to Me!”

As educators, we aim for students to seek, identify, and utilize a range of feedback to gain an understanding of their present performance in relation to learning goals, and ultimately to identify and use tools to close the gap between present and desired performance. We strive for all students to be their “own first assessors”—intelligent deciders—and develop the independence to self-assess the quality of their own work when they leave higher education institutions and enter the workforce. For students with a print disability such as vision impairment or blindness, traditional forms of feedback may not be successful in providing the information they need to close the gap. The most important issue for these students is access to feedback and agency in the feedback conversation. It is incumbent on higher education educators to find ways to provide equity of access to the provision and reception of feedback for all students. As such, this chapter explores ways for providing feedback to students with a vision impairment to ensure they are able to contextualize and utilize the feedback to improve learning outcomes. This is achieved by aligning the use of mobile technologies and audio feedback with the key principles of connectivism—autonomy, connectedness, diversity, and openness—to provide educators with recommendations.

The Association of Sleep Duration With Vision Impairment in Middle-Aged and Elderly Adults: Evidence From the China Health and Retirement Longitudinal Study

Objective: This study aims to investigate the association of sleep duration with vision impairment (VI) in middle-aged and elderly adults.Methods: This cross-sectional study used the data from the baseline survey of the China Health and Retirement Longitudinal Study (CHARLS) 2011–2012, a national survey of adults aged 45 years or older. Weighted multilevel logistic regression models were used to evaluate the association between self-reported sleep duration and VI.Results: Of the 13,959 survey respondents, a total of 4,776 (34.2%) reported VI. The prevalence of short (≤6 h/night) and long (>8 h/night) sleep durations was higher among respondents with VI than those without VI (P < 0.001). Multilevel logistic regression models showed that compared with a sleep duration of 6–8 h/night, a sleep duration of ≤6 h/night was associated with a 1.45-fold [95% confidence interval (CI) = 1.34–1.56] higher VI risk, and a sleep duration of >8 h/night was associated with a 1.18-fold (95% CI = 1.03–1.34) higher VI risk, after adjusting for sociodemographic data, lifestyle factors, and health conditions. Vision impairment was associated with short sleep duration in respondents from all age or gender categories. However, VI was associated with long sleep duration in respondents from the elderly or female categories. The association between VI and long sleep duration disappeared in respondents of middle-aged or male categories.Conclusions: The potential impact of sleep on the risk of visual functions requires further attention. A more comprehensive and integrated health care and rehabilitation system covering vision and sleep is also needed.

Prevalence of blindness and distance vision impairment in the Gambia across three decades of eye health programming

Background/aimsThe 1986 Gambia National Eye Health Survey provided baseline data for a National Eye Health Programme. A second survey in 1996 evaluated changes in population eye health a decade later. We completed a third survey in 2019, to determine the current state of population eye health, considering service developments and demographic change.MethodsWe estimated prevalence and causes of vision impairment (VI) in a nationally representative population-based sample of adults 35 years and older. We used multistage cluster random sampling to sample 10 800 adults 35 and above in 360 clusters of 30. We measured monocular distance visual acuity (uncorrected and with available correction) using Peek Acuity. Participants with either eye uncorrected or presenting (with available correction) acuity <6/12 were retested with pinhole and refraction, and dilated exams were completed on all eyes by ophthalmologists using a direct ophthalmoscope, slit lamp and 90 D lens.ResultsWe examined 9188 participants (response rate 83%). The 2013 census age–sex adjusted prevalence of blindness (presenting acuity<3/60 in better seeing eye) was 1.2% (95% CI 0.9 to 1.4) and of moderate or severe VI (MSVI,<6/18 to ≥3/60) was 8.9% (95% CI 9.1 to 9.7). Prevalence of all distance VI (<6/12) was 13.4% (12.4–14.4). Compared with 1996, the relative risk of blindness decreased (risk ratio 0.7, 95% CI 0.5 to 1.0) and MSVI increased (risk ratio 1.5, 95% CI 1.2 to 0.17).ConclusionSignificant progress has been made to reduce blindness and increase access to eye health across the Gambia, with further work is needed to decrease the risk of MSVI.

Relationship between Visual Impairment and the Use of Electronic Devices in Kingdom of Saudi Arabia: A Cross-Sectional Study

Background: Overuse of electronic gadgets has been highlighted as a possible preventable risk factor for eyesight loss. Excessive use of electronic gadgets, on the other hand, has been linked to vision impairment in a variety of ways. Methods: This was an analytical cross-sectional study to spotlight on the relationship between visual impairment and addiction to electronic devices use. The study's goal was to see if there was a link between Saudis' vision impairment and their addiction to using electronic devices, this is the suitable design for this research. The study was carried out among Saudi population. Data were collected from general population using questionnaire during the period from 22 August to 22 November 2020. Results: The study included the participation of 344 participants from both genders and different age groups in the Kingdom of Saudi Arabia. There were 211 female participants (61.3%) and 133 males (38.7%) took place in this study. The most prevalent age group was under the age of 25 years (n= 111, 32.3%) followed by the age group 25-35 (n= 104, 30.2%) while the least frequent age group was above 45 years (n= 54, 15.7%). On asking the participants whether they think that they have vision impairment or not, their answers were as follows: yes (n= 156, 45.3%), no (n= 131, 38.1) and maybe (n= 57, 16.6%). Due to the use electronic devices, there were 107 participants complained of headache (31.1%). And this was significantly related to the number of hours spent by study participants using electronic devices (P= 0.002) as well as significant for female gender more than male gender (P= 0.03). Conclusion: The study showed statistically significant relationship between the number of hours spent on using electronic devices and visual impairment among study participants especially among female population more than male population. There is a need for awareness campaigns to increase health awareness among population to cut down the use of electronic devices.