Sensory impairments and physical disability in aged women living at home.
BACKGROUND
Studies of the impact of visual or hearing impairments on physical disability in older people have provided conflicting results. Furthermore, the consequences of the loss of such visual functions as depth perception or contrast sensitivity have rarely been studied. We examined the relationship of visual acuity, depth perception, contrast sensitivity, and hearing difficulty to the ability of older women living at home to accomplish instrumental activities of daily living independently.


METHODS
Data on self-reported physical disability and hearing impairment, as well as objective measures of functional vision and physical ability were collected from a sample of 1210 community-dwelling women aged 75 years and older. Multivariate logistic regression modelling was used to assess the strength of the association between physical disability and sensory impairments, controlling for age, education level, motor limitations, and prevalent chronic diseases.


RESULTS
Women with low visual acuity or low contrast sensitivity were significantly more likely to be physically dependent than women with good vision. Contrast sensitivity was, however, a better predictor than functional acuity, after controlling for age, education level, motor limitations and chronic medical conditions (adjusted odds ratio: 5.1; 95% confidence interval: 2.0-12.9). Depth perception was not related to physical disability. Women with serious hearing difficulty had significantly increased odds of dependency (4.1; 1. 4-12.1).


CONCLUSIONS
Severe sensory impairments are strongly related to physical dependency in older women. It may be useful to add a test of contrast sensitivity to the traditional acuity test to predict better which elderly individuals may have difficulty carrying out routine daily activities.
Dargent-Molina
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P
Institut National de la Santé et de la Recherche Médicale, Unite 149,16 av. Paul Vaillant-Couturier, 94807 Villejuif Cedex, France.
Hays
M
M
Bréart
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G
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities; D005260:Female; D015577:Geriatric Assessment; D006311:Hearing Disorders / Q000150:complications*; D006801:Humans; D016015:Logistic Models; D014786:Vision Disorders / Q000150:complications*; D014792:Visual Acuity; D014796:Visual Perception