The elderly population is at increased risk of visual impairment and loss of functional independence. Little is known about either the pathophysiological causes of visual impairment, other than reduced visual acuity, or about the impact of visual impairment on functional disability. We propose to examine a representative sample of 2320 community-dwelling persons 65 to 84 years of age who reside in Salisbury, MD, to determine the association between specific components of visual loss (e.g. reduced contrast sensitivity or visual field defects) and specific types of functional disability (e.g. impaired mobility or reading). Visual impairment will be evaluated with psychophysical measures of static and dynamic visual acuity, contrast sensitivity, glare sensitivity, glare recovery, scotopic sensitivity, visual fields, and stereoacuity. Functional disability will be evaluated with standardized questionnaires and performance-based measures of reading, face recognition, mobility, and representative daily activities (ADLs and IADLs). All participants will receive a comprehensive assessment of co-morbid conditions such as arthritis and cardiovascular disease, and effect modifiers such as cognitive and psychosocial factors as part of Core Project B. We will determine how co-morbid conditions and effect modifiers alter the association of visual impairment with functional disability. Ocular disease will be assessed by photographs of the lens and macula, and by clinical examination of all participants who are visually impaired. We will determine the extent to which age-related visual changes can be attributed to pathological causes, including early changes in the lens and macula. Each participant will be evaluated twice during the course of this five-year study, separated by a 20-month interval. This will provide an opportunity to evaluate prospectively the relationship between the development of visual impairment and changes in functional status. A better understanding of the manner in which visual impairment limits performance of specific tasks can provide the basis for developing targeted interventions to maximize function in older individuals.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Program Projects (P01)
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Johns Hopkins University
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Zheng, D Diane; Bokman, Christine L; Lam, Byron L et al. (2016) Longitudinal relationships between visual acuity and severe depressive symptoms in older adults: the Salisbury Eye Evaluation study. Aging Ment Health 20:295-302
Zebardast, Nazlee; Swenor, Bonnielin K; van Landingham, Suzanne W et al. (2015) Comparing the Impact of Refractive and Nonrefractive Vision Loss on Functioning and Disability: The Salisbury Eye Evaluation. Ophthalmology 122:1102-10
Christ, Sharon L; Zheng, D Diane; Swenor, Bonnielin K et al. (2014) Longitudinal relationships among visual acuity, daily functional status, and mortality: the Salisbury Eye Evaluation Study. JAMA Ophthalmol 132:1400-6
Swenor, Bonnielin K; Muñoz, Beatriz; West, Sheila K (2014) A longitudinal study of the association between visual impairment and mobility performance in older adults: the salisbury eye evaluation study. Am J Epidemiol 179:313-22
Swenor, Bonnielin K; Bandeen-Roche, Karen; Muñoz, Beatriz et al. (2014) Does walking speed mediate the association between visual impairment and self-report of mobility disability? The Salisbury Eye Evaluation Study. J Am Geriatr Soc 62:1540-5
Storey, Philip; Munoz, Beatriz; Friedman, David et al. (2013) Racial differences in lens opacity incidence and progression: the Salisbury Eye Evaluation (SEE) study. Invest Ophthalmol Vis Sci 54:3010-8
Swenor, Bonnielin K; Muñoz, Beatriz; West, Sheila K (2013) Does visual impairment affect mobility over time? The Salisbury Eye Evaluation Study. Invest Ophthalmol Vis Sci 54:7683-90
Lee, Bryan S; Munoz, Beatriz E; West, Sheila K et al. (2013) Functional improvement after one- and two-eye cataract surgery in the Salisbury Eye Evaluation. Ophthalmology 120:949-55
Swenor, Bonnielin K; Bressler, Susan; Caulfield, Laura et al. (2010) The impact of fish and shellfish consumption on age-related macular degeneration. Ophthalmology 117:2395-401
Cross, J M; McGwin Jr, G; Rubin, G S et al. (2009) Visual and medical risk factors for motor vehicle collision involvement among older drivers. Br J Ophthalmol 93:400-4

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