Age-related macular degeneration (ARMD) is the leading cause of permanent vision loss in the elderly. It affects one out of five persons over age 65 and causes more vision loss than diabetic retinopathy and glaucoma combined. The investigators' pilot data indicate that ARMD vision loss is associated with significant disability and distress, and that a six session behavioral medicine intervention can reduce distress and increase ARMD related self-efficacy in elderly patients with ARMD. Since ARMD cannot at present be prevented or cured, the proposed intervention will aid the afflicted in more effectively coping with disability, and this will potentially improve overall quality of life. Research objectives are 1) to characterize the disability due to macular degeneration at two levels of vision loss (legal blindness and the legal limit of visual acuity for driver's license); 2) to demonstrate the efficacy of a 6 week, easily reproducible, behavioral medicine intervention in reducing distress, improving functional status, and enhancing quality of life; and 3) to establish professional standards to implement the intervention in community settings. The proposed study design is a randomized 2 (behavioral medicine intervention group, self help attention control group) x 3 (baseline, post-intervention, six month assessment) mixed between (treatment condition) and within (assessment period) groups experiment. Participants (N=150) will be stratified by vision level, gender, and ethnic group to assure equal distribution across groups. The primary dependent measures at each assessment point will be mood, disability in daily functioning, and life quality. Potential moderating factors to be assessed include health status, medical history, ARMD-related self-efficacy, dispositional optimism and social support.
| Brody, Barbara L; Roch-Levecq, Anne-Catherine; Kaplan, Robert M et al. (2006) Age-related macular degeneration: self-management and reduction of depressive symptoms in a randomized, controlled study. J Am Geriatr Soc 54:1557-62 |
| Brody, Barbara L; Roch-Levecq, Anne-Catherine; Thomas, Ronald G et al. (2005) Self-management of age-related macular degeneration at the 6-month follow-up: a randomized controlled trial. Arch Ophthalmol 123:46-53 |
| Brody, Barbara L; Roch-Levecq, Anne-Catherine; Gamst, Anthony C et al. (2002) Self-management of age-related macular degeneration and quality of life: a randomized controlled trial. Arch Ophthalmol 120:1477-83 |
| Brody, B L; Gamst, A C; Williams, R A et al. (2001) Depression, visual acuity, comorbidity, and disability associated with age-related macular degeneration. Ophthalmology 108:1893-900; discussion 1900-1 |
