title: Comorbid cognitive impairment and functional trajectories in low vision rehabilitation for macular disease.
abstract: OBJECTIVE
  Comorbid cognitive impairment is common among visually impaired older adults. This study investigated whether baseline cognitive status predicts functional trajectories among older adults in low vision rehabilitation (LVR) for macular disease.
  
  
  METHODS
  The Telephone Interview for Cognitive Status - modified (TICS-m) was administered to macular disease patients aged ≥ 65 years receiving outpatient LVR. Mixed models assessed the rate of change in instrumental activities of daily living and visual function measures over a mean follow-up of 115 days.
  
  
  RESULTS
  Of 91 participants, 17 (18.7%) had cognitive impairment (TICS-m score ≤ 27) and 23 (25.3%) had marginal impairment (TICS-m scores 28 to 30). Controlling for age and gender, baseline cognitive status did not predict most functional outcomes. However, participants with marginal cognitive impairment experienced worse functional trajectories in ability to prepare meals (p=0.03) and activities that require distance vision (p=0.05).
  
  
  CONCLUSIONS
  Patients with mild to moderate cognitive impairment should not be excluded from LVR, but programs should be prepared to detect and accommodate a range of cognitive ability.
authors.affiliation: Aging Center, Duke University Medical Center, DUMC 3003, Durham, NC 27710, USA. heather.whitson@duke.edu
authors.forename: Heather E
authors.initials: HE
authors.lastname: Whitson
authors.forename: Deidra
authors.initials: D
authors.lastname: Ansah
authors.forename: Linda L
authors.initials: LL
authors.lastname: Sanders
authors.forename: Diane
authors.initials: D
authors.lastname: Whitaker
authors.forename: Guy G
authors.initials: GG
authors.lastname: Potter
authors.forename: Scott W
authors.initials: SW
authors.lastname: Cousins
authors.forename: David C
authors.initials: DC
authors.lastname: Steffens
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Landerman
authors.forename: Carl F
authors.initials: CF
authors.lastname: Pieper
authors.forename: Harvey Jay
authors.initials: HJ
authors.lastname: Cohen
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D007407:Interviews as Topic; D008268:Macular Degeneration / Q000453:epidemiology* / Q000534:rehabilitation*; D008297:Male; D015354:Vision, Low / Q000534:rehabilitation*