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Abstract

Objectives: Our study investigates measurement, correlates, and functional associations of vision impairment (VI) in an aging population in rural South Africa. Methods: 1582 participants aged 40–69 reported on near (NVI) and distance vision impairment (DVI) and completed objective vision tests. Logistic and linear regression were used to evaluate sociodemographic, health, and psychosocial correlates of VI and assess relationships between VI and cognitive and physical function. Results: VI prevalence was considerably higher according to objective testing (56%) versus self-reports (18%). Older adults were especially likely to underreport impairment. Objective VI was associated with age, education, cardiometabolic disease, and female sex. Conversely, self-reported VI was associated with psychosocial factors. Objective NVI and both types of DVI were associated with worse visual cognition and slower gait speed, respectively. Discussion: Self-reported and objective VI measures should not be used interchangeably in this context. Our findings highlight extensive burden of untreated VI in this region.

Keywords

vision impairment cognitive function physical function measurement sub-Saharan Africa

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References

Adams

L. B.

Farrell

Mall

Mahlalela

Berkman

(2020). Dimensionality and differential item endorsement of depressive symptoms among aging black populations in South Africa: Findings from the HAALSI study. Journal of Affective Disorders, 277, 850-856. doi:10.1016/j.jad.2020.08.073.

(2011). Participation of the elderly after vision loss. Disability and Rehabilitation, 33(1), 63-72.

, (2017). Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: A systematic review and meta-analysis. The Lancet Global Health, 5(9), e888-e897.

(2003). Evaluating a new logMAR chart designed to improve visual acuity assessment in population-based surveys. Eye, 17(6), 754-758.

(2013). Causes of vision loss worldwide, 1990-2010: A systematic analysis. The Lancet Global Health, 1(6), e339-e349.

(2019). Decline in instrumental activities of daily living over 4-year: The association with hearing, visual and dual sensory impairments among non-institutionalized women. The Journal of Nutrition, Health & Aging, 23(8), 687-693.

(2018). Multiple sensory impairment is associated with increased risk of dementia among black and white older adults. The Journals of Gerontology: Series A, 74(6), 890-896. doi:10.1093/gerona/gly264.

Cantril

(1965). The Pattern of human concerns. Rutgers University Press.

(2017). Association of vision loss with cognition in older adults. JAMA Ophthalmology, 135(9), 963-970.

(2014). Longitudinal Relationships Among Visual Acuity, Daily Functional Status, and Mortality. JAMA Ophthalmology, 132(12), 1400-1406. doi:10.1001/jamaophthalmol.2014.2847.

(2015). Examining the pathways between self-awareness and well-being in mild to moderate Alzheimer disease. The American Journal of Geriatric Psychiatry, 23(12), 1297-1306.

(2018). A link between subjective perceptions of memory and physical function: Implications for subjective cognitive decline. Journal of Alzheimer’s Disease, 61, 1387-1398. doi:10.3233/JAD-170495.

(2018). The association amongst visual, hearing, and dual sensory loss with depression and anxiety over 6 years: The Tromsø study. International Journal of Geriatric Psychiatry, 33(4), 598-605.

(2017). Visual acuity and self-reported vision status. Journal of Aging and Health, 29(1), 128-148.

(2009). Using self-rated health for analysing social inequalities in health: A risk for underestimating the gap between socioeconomic groups?. Journal of Epidemiology and Community Health, 63(6), 426-432.

(2010). Wealth and happiness across the world: material prosperity predicts life evaluation, whereas psychosocial prosperity predicts positive feeling. Journal of Personality and Social Psychology, 99(1), 52-61.

(2004). Center for epidemiologic studies depression scale: Review and revision. CESD and CESD-R.

(2019). Prevalence of falls and fall-related outcomes in older adults with self-reported vision impairment. Journal of the American Geriatrics Society, 67(2), 239-245.

(2019). Vision impairment and receipt of eye care among older adults in low- and middle-income countries. JAMA Ophthalmology, 137(2), 146-158.

(2012). Discrepancies in the concordance of self-reported vision status and visual acuity in the salisbury eye evaluation study. Ophthalmology, 119(1), 106-111.

(2020). Education disparity only partially explains cognitive gender differences in older rural South Africans. The Journals of Gerontology: Series B. 75(7), e161-e173.

(2001). Estimating wealth effects without expenditure data-or tears: An application to educational enrollments in states of India. Demography, 38(1), 115-132.

(2014). Epidemiology of myopia. Eye, 28(2), 202-208. doi:10.1038/eye.2013.280.

(2019). Longitudinal associations of self-reported vision impairment with symptoms of anxiety and depression among older adults in the United States. JAMA Ophthalmology, 137(7), 793-800.

(2018). Global prevalence of presbyopia and vision impairment from uncorrected presbyopia. Ophthalmology, 125(10), 1492-1499.

(2015). The global burden of potential productivity loss from uncorrected presbyopia. Ophthalmology, 122(8), 1706-1710.

27.

Glass

J. M.

(2007). Visual function and cognitive aging: differential role of contrast sensitivity in verbal versus spatial tasks. Psychology and Aging, 22(2), 233-238. doi:10.1037/0882-7974.22.2.233.

(2018). Cohort profile: Health and ageing in Africa: A longitudinal study of an INDEPTH community in South Africa (HAALSI). International Journal of Epidemiology, 47(3), 689-690.

(2020). Age and gender differences in social network composition and social support among older rural South Africans: Findings from the HAALSI study. The Journals of Gerontology: Series B, 75(1), 148-159.

(2012). Prevalence and correction of near vision impairment at seven sites in China, India, Nepal, Niger, South Africa, and the United States. American Journal of Ophthalmology, 154(1), 107-116. doi:10.1016/j.ajo.2012.01.026

(2009). Altered vision destabilizes gait in older persons. Gait & Posture, 30(2), 233-238.

(2008). Global vision impairment due to uncorrected presbyopia. Archives of Ophthalmology, 126(12), 1731-1739.

(2015). Towards better estimates of uncorrected presbyopia. Scielo Public Health. 93(10), 667.

(2013) Applied logistic regression (Vol. 398). John Wiley & Sons.

(2017). Cognitive function in low-income and low-literacy settings: Validation of the tablet-based oxford cognitive screen in the health and aging in Africa: A longitudinal study of an INDEPTH community in South Africa (HAALSI). The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 72(1), 38-50.

(2009). Tracking population health based on self-reported impairments: Trends in the prevalence of hearing loss in US adults, 1976-2006. American Journal of Epidemiology, 170(1), 80-87.

37.

Kahneman

Deaton

(2010). High income improves evaluation of life but not emotional well-being. Proceedings of the National Academy of Sciences, 107(38), 16489-16493.

(2003). Associations of visual function with physical outcomes and limitations 5 years later in an older population. Ophthalmology, 110(4), 644-650. doi:10.1016/S0161-6420(02)01935-8 .

39.

Kliegel

Zimprich

(2005). Predictors of cognitive complaints in older adults: A mixture regression approach. European Journal of Ageing, 2(1), 13-23.

(2019). Cognitive function and impairment in older, Rural South African Adults: Evidence from “health and aging in Africa: A longitudinal study of an INDEPTH community in Rural South Africa”. Neuroepidemiology, 52(1-2), 32-40. doi:10.1159/000493483.

(2012). Data resource profile: The world health organization study on global ageing and adult health (SAGE). International Journal of Epidemiology, 41(6), 1639-1649.

(1992). The relationship of vision and hearing impairment to one-year mortality and functional decline. Journal of Aging and Health, 4(1), 126-148. doi:10.1177/089826439200400108.

(2002). Visual acuity impairment and mortality in US adults. Archives of Ophthalmology, 120(11), 1544-1550. doi:10.1001/archopht.120.11.1544.

(2016). Socio-demographic characteristics, lifestyle factors and burden of morbidity associated with self-reported hearing and vision impairments in older British community-dwelling men: A cross-sectional study. Journal of Public Health, 38(2), e21-e28.

(2011). Falls, injuries from falls, health related quality of life and mortality in older adults with vision and hearing impairment-Is there a gender difference? Maturitas, 69(4), 359-364. doi:10.1016/j.maturitas.2011.05.006.

(2015). Subjective beliefs, memory and functional health: Change and associations over 12 years in the Australian longitudinal study of ageing. Gerontology, 61(3), 241-250.

(2018). Visual and hearing impairments are associated with cognitive decline in older people. Age and Ageing, 47(4), 575-581.

, (2019). Associations between self-reported sensory impairment and risk of cognitive decline and impairment in the health and retirement study cohort. The Journals of Gerontology: Series B, 75, 1230-1242. doi:10.1093/geronb/gbz043.

49.

McHugh

M. L.

(2012). Interrater reliability: The kappa statistic. Biochemia Medica, 22(3), 276-282.

(2020). Prevalence and causes of vision loss in sub-Saharan Africa in 2015: Magnitude, temporal trends and projections. British Journal of Ophthalmology, 104, 1658-1668. doi:10.1136/bjophthalmol-2019-315217.

51.

National Academies of Sciences, E, & Medicine (2017). Making eye health a population health imperative: Vision for tomorrow. National Academies Press., & Medicine.

(2006). Impact of presbyopia on quality of life in a rural African setting. Ophthalmology, 113(5), 728-734.

(2017). Physical function in an aging population in rural South Africa: Findings from HAALSI and cross-national comparisons with HRS sister studies. The Journals of Gerontology: Series B, 72(4), 665-679.

(2014). Sensory function: Insights from wave 2 of the national social life, health, and aging project. The Journals of Gerontology: Series B, 69(Suppl_2), S144-S153.

(2019). Health inequalities in the South African elderly: The importance of the measure of social-economic status. The Journal of the Economics of Ageing, 14, 100191.

56.

Robinson-Whelen

Kiecolt-Glaser

(1997). The importance of social versus temporal comparison appraisals among older adults1. Journal of Applied Social Psychology, 27, 959-966.

(2017). Sensory impairments and cognitive function in middle-aged adults. The Journals of Gerontology: Series A, 72(8), 1087-1090.

(2000). Association between depression and mortality in older adults. Archives of Internal Medicine, 160(12), 1761-1768.

(2013). Social isolation, loneliness, and all-cause mortality in older men and women. Proceedings of the National Academy of Sciences, 110(15), 5797-5801.

(2010). Assessing the performance of prediction models. Epidemiology, 21(1), 128-138. doi:10.1097/EDE.0b013e3181c30fb2.

(n.d.). Near vision impairment: Presbyopia also deserves attention. http://atlas.iapb.org/vision-trends/near-vision-impairment-presbyopia-also-deserves-attention/

62.

Taylor

H. R.

(1978). Applying new design principles to the construction of an illiterate E chart. Optometry and Vision Science, 55(5), 348-351.

63.

Varadaraj

Lee

M. J.

Tian

Ramulu

P. Y.

Bandeen-Roche

Swenor

B. K.

(2019). Near vision impairment and Frailty: Evidence of an association. American Journal of Ophthalmology, 208, 234-241.

64.

Wettstein

Spuling

S. M.

Hans-Werner

Heyl

(2021). Associations of self-reported vision problems with health and psychosocial functioning: A 9-year longitudinal perspective. British Journal of Visual Impairment, 39(1), 31-52.

65.

Whillans

Nazroo

(2014). Assessment of visual impairment: The relationship between self-reported vision and 'gold-standard' measured visual acuity. British Journal of Visual Impairment, 32(3), 236-248.

66.

World Health Organization (2019). World report on vision.

67.

Xiang

Freedman

V. A.

Shah

R. X.

Stagg

B. C.

Ehrlich

J. R.

(2019). Self-reported vision impairment and subjective well-being in older adults: A longitudinal mediation analysis. The Journals of Gerontology: Series A, 75(3), 589-595. doi:10.1093/gerona/glz148.

68.

Zambelli-Weiner

Friedman

D. S.

(2012). Building a basis for action: Enhancing public health surveillance of vision impairment and eye health in the United States. American Journal of Ophthalmology, 154(6), S8-S22.

69.

Zebardast

Friedman

D. S.

Vitale

(2017). The prevalence and demographic associations of presenting near-vision impairment among adults living in the United States. American Journal of Ophthalmology, 174, 134-144.

70.

Zhang

Zhao

Liu

Xia

Hou

Dong

(2020). Sensory impairment and all-cause mortality among the oldest-old: Findings from the Chinese longitudinal healthy longevity survey (CLHLS). The Journal of Nutrition, Health & Aging, 24(2), 132-137. doi:10.1007/s12603-020-1319-2.

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Do You See What Eye See? Measurement,Correlates,and Functional Associations of Objective and Self-Reported Vision Impairment in Aging South Africans

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