title: The association of multiple visual impairments with self-reported visual disability: SEE project.
abstract: OBJECTIVE
  This report examines the relationship between psychophysical measures of visual impairment and self-reported difficulty with everyday visual tasks in a population-based sample of individuals 65 years of age and older.
  
  
  METHODS
  Community-dwelling residents (n = 2520) of Salisbury, MD, between the ages of 65 and 84 were recruited for the study. Visual acuity under normal and low luminance, contrast and glare sensitivity, stereoacuity, and visual fields were measured. Subjective physical disability was assessed with the Activities of Daily Vision Scale (ADVS).
  
  
  RESULTS
  In multiple regression analyses adjusted for demographic factors, cognitive status, depression, and number of comorbid medical conditions, each of the vision tests except low luminance acuity was independently associated with lower ADVS scores. The analyses indicate that a factor of 2 reduction in visual acuity or contrast sensitivity, comparable with that observed in mild to moderate lens opacity, was associated with a three- to fivefold odds of reporting difficulty with daily tasks. Although age alone was a significant risk factor for disability, it was not associated with overall ADVS score, once visual impairment and other chronic medical conditions were taken into account.
  
  
  CONCLUSIONS
  Visual acuity, contrast and glare sensitivity, stereoacuity, and visual fields are significant independent risk factors for self-reported visual disability in an older population. Visual impairment defined by acuity alone is not the only dimension of the association with subjective disability. Additional vision measures are required to understand the impact of vision loss on everyday life.
authors.affiliation: Lions Vision Center, Department of Biostatistics, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. g.rubin@ucl.ac.uk
authors.forename: G S
authors.initials: GS
authors.lastname: Rubin
authors.forename: K
authors.initials: K
authors.lastname: Bandeen-Roche
authors.forename: G H
authors.initials: GH
authors.lastname: Huang
authors.forename: B
authors.initials: B
authors.lastname: Muñoz
authors.forename: O D
authors.initials: OD
authors.lastname: Schein
authors.forename: L P
authors.initials: LP
authors.lastname: Fried
authors.forename: S K
authors.initials: SK
authors.lastname: West
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015350:Contrast Sensitivity; D004185:Disability Evaluation; D005260:Female; D019466:Glare; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008396:Maryland / Q000453:epidemiology; D012307:Risk Factors; D012650:Self Disclosure; D014786:Vision Disorders / Q000175:diagnosis* / Q000453:epidemiology; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data