title: A randomized controlled trial of a health-promotion programme and its effect on ADL dependence and self-reported health problems for the elderly visually impaired.
abstract: BACKGROUND
  Ageing with visual impairment is associated with a high degree of disability whereby age-related macular degeneration in particular causes dependence in activities of daily living (ADL) even at an early stage.
  
  
  OBJECTIVE
  To compare an activity-based, health-promotion programme with an individual programme, targeting the elderly with age-related macular degeneration concerning the effect on the development of dependence in ADL, general health, and self-reported health problems.
  
  
  METHODS
  A randomized controlled study with a 28-month follow-up. A total of 229 persons were randomized to the study and 131 (57%) were followed up (individual intervention n=69, health-promotion programme n=62) at 28-month.
  
  
  RESULTS
  The health-promotion group maintained their ADL level despite a significant decrease in visual acuity, while the individual intervention group increased its dependence in ADL. General health systematically dropped to a lower level in both groups, but participants from the health-promotion group reported fewer health problems. There were significantly fewer reports of tiredness and dizziness among the health-promotion participants.
  
  
  CONCLUSIONS
  The health-promotion programme seems to have slowed down the disablement process among elderly with decreased vision by enabling them to maintain their ADL level and by reducing self-reported health problems for at least 28 months following intervention.
authors.affiliation: Department of Neurology and Physiology, Sahlgrenska Academy at Göteborg University, Sweden. kajsa.Eklund@gu.se
authors.forename: Kajsa
authors.initials: K
authors.lastname: Eklund
authors.forename: Johan
authors.initials: J
authors.lastname: Sjöstrand
authors.forename: Synneve
authors.initials: S
authors.lastname: Dahlin-Ivanoff
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006293:Health Promotion; D006304:Health Status; D006801:Humans; D008268:Macular Degeneration / Q000534:rehabilitation*; D008297:Male; D009788:Occupational Therapy / Q000379:methods*; D013548:Sweden; D015354:Vision, Low / Q000534:rehabilitation*; D014792:Visual Acuity