Eye disease poses isolation danger in seniors

Older adults whose vision is impaired by age-related macular degeneration (AMD) change their travel patterns in ways that increase isolation and decrease their quality of life, according to a study by Frank C. Curriero, PhD, of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and colleagues.

Such changes add another item to a list of negative effects already associated with eyesight difficulties in seniors, the authors say. “Visual impairment has been shown to affect several aspects of mobility, producing worse balance, more falls, greater fear of falling, decreased physical activity, slower/more hazardous movement through the environment, and more frequent driving cessation,” they write in JAMA Ophthalmology, adding that travel restrictions may lead to mood changes or depression in some people who have AMD.

Researchers used cellular tracking devices to record the travel patterns of 61 control participants with normal vision, 84 study subjects with glaucoma and visual field loss in both eyes, and 65 people with AMD with severe loss of visual acuity in one or both eyes. Participants’ locations were tracked every 15 minutes between 7 a.m. and 11 p.m. for seven days.

The study measured the average maximum distance the seniors traveled from their residences and the average maximum span of travel. Investigators found that average maximum distance traveled away from place of residence and average maximum span of travel decreased by 0.25 miles for each line of visual acuity loss as measured by an eye test. The researchers observed similar effects in those with visual field loss due to glaucoma, although the association was not statistically significant.

The authors note that the mobility restriction they saw may be the result of social isolation, not the cause of it. Nonetheless, they conclude: “Validated strategies to motivate and safely enable travel may be an important aspect of low-vision rehabilitation in individuals with poor vision from AMD.”

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