Psychosocial Intervention &Effects of ARMD

Brown, Stuart

Abstract

The aim of this proposal is to identify predictors of resilience and adaptation in the face of advanced age-related macular degeneration (AMD) vision loss and to determine if the positive effects of psychosocial intervention (self -management) hold at 6 months follow up. We propose to conduct secondary analyses of data obtained from 252 elderly subjects with irreversible vision loss due to AMD who participated in a 6-week prospective community-based randomized trial of a psychosocial intervention. Secondary cross-sectional analyses will be conducted of the entire sample at baseline. Secondary longitudinal analyses will be conducted on the 214 participants for whom 6-month data was obtained. Special sub-population analyses will be conducted on data from the control group who were observed at 3 time points to observe the natural history of adaptation over a 6 month period.
Specific aims : 1. Determine the long-term effectiveness of treatment at 6 months follow-up. 2. To explain outcomes of treatment by measures of psychological adaptation. 3. Determine what factors significantly predict resilience assessed by visual functioning as measured by NEI-VFQ. Method: This study includes 252 subjects affected by AMD followed over 6 months who were randomized into 3 treatment groups. The first group was the experimental group assigned to participation in a self-management program, the second group participated in an education program about macular degeneration through audiotapes. Finally the third group was a waiting list. The outcomes measures are available for the 3 groups. Significance: This proposed secondary hypotheses analysis of elderly subjects with AMD will contribute to evaluation of the effectiveness of a cognitively based intervention program, and will add significantly to the understanding of psychosocial factors associated with either disability or resilience.