Longitudinal analysis of the relationship between regular eye examinations and changes in visual and functional status.
OBJECTIVE
To determine whether regular eye examinations are associated with a greater or lesser rate of loss of ability to read newsprint, onset of blindness or low vision, or onset of limitations in instrumental activities of daily living (IADLs) and activities of daily living (ADLs).


METHODS
A sample of 14,215 Medicare beneficiaries observed between 1994 and 1999 linked to the 1994 and 1999 National Long-Term Care Surveys (NLTCS). Effects of annual examinations were assessed using instrumental variables.


METHODS
The Medicare-linked NLTCS is representative of U.S. elderly persons from 1994 to 1999.


METHODS
Longitudinal observational study of persons aged 65 and older.


METHODS
Change in self-reported and provider-reported vision and change in functional limitations associated with vision related to the number of years with eye examinations and other factors.


RESULTS
Persons with more-regular eye examinations between 1994 and 1998 were less likely to have experienced a decline in vision or in functional status between 1994 and 1999. On average, an additional year with an eye examination was associated with a decrease in the probability of becoming unable to read newsprint of 0.12 (P=.03), a lower probability of onset of low vision or blindness of 0.009 (P=.06), and a decrease in the probability that the number of functional limitations increased of 0.13 (P=.002) for IADLs and 0.05 (P=.003) for ADLs.


CONCLUSIONS
Elderly persons who have regular eye examinations experience less decline in vision and functional status.
Sloan
Frank A
FA
Center for Health Policy, Law, and Management, Terry Sanford Institute of Public Policy, Duke University, Durham, North Carolina 27708, USA. fsloan@hpolicy.duke.edu
Picone
Gabriel
G
Brown
Derek S
DS
Lee
Paul P
PP
D000203:Activities of Daily Living / Q000145:classification*; D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D003941:Diagnostic Techniques, Ophthalmological / Q000706:statistics & numerical data*; D005128:Eye Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D015577:Geriatric Assessment; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017410:Practice Guidelines as Topic; D011336:Probability; D013223:Statistics as Topic; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data; D014786:Vision Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D014792:Visual Acuity