title: Visual acuity in institutionalized seniors with moderate to severe dementia.
abstract: OBJECTIVE
  The evaluation of visual acuity (VA) in cognitively impaired older individuals may be limited by a reduced ability to cooperate or communicate. The objective of this research was to assess VA in older institutionalized individuals with cognitive impairment, including severe dementia, using various acuity charts.
  
  
  METHODS
  Three groups of 30 participants each were recruited: (1) young participants; (2) older participants with no history of cognitive or communication disorders; and (3) older participants with cognitive impairment, including severe dementia, residing in long term care facilities. The Mini-Mental State Examination was performed for each institutionalized subject. VA was measured using 6 validated charts [Snellen, Teller cards, Early Treatment Diabetic Retinopathy Study (ETDRS)-letters, -numbers, -Patty Pics, -Tumbling Es] presented in random order. Nonparametric tests were used to compare VA scores between charts, after Bonferroni-Holm corrections for multiple comparisons.
  
  
  RESULTS
  Participants in groups 1 and 2 responded to all charts. A large proportion of participants with dementia responded to all charts (n = 19), whereas only one did not respond to any chart. In group 3, VA charts with the lowest scores were the Teller cards (20/65) and Patty Pics (20/62), regardless of the level of dementia, whereas the highest VA scores were obtained with the Snellen (20/35) and ETDRS-letter (20/36) charts. Across all groups, the ETDRS-letter chart was the only one whose scores did not differ from those obtained with the standard Snellen chart.
  
  
  CONCLUSIONS
  Visual acuity can be measured, and should at least be attempted, in older cognitively impaired individuals having a reduced ability to communicate.
authors.affiliation: School of Optometry, Université de Montréal, Montréal, Canada. stephaniechriqui@hotmail.com
authors.forename: Estefania
authors.initials: E
authors.lastname: Chriqui
authors.forename: Marie-Jeanne
authors.initials: MJ
authors.lastname: Kergoat
authors.forename: Nathalie
authors.initials: N
authors.lastname: Champoux
authors.forename: Bernard-Simon
authors.initials: BS
authors.lastname: Leclerc
authors.forename: Hélène
authors.initials: H
authors.lastname: Kergoat
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000150:complications*; D018450:Disease Progression; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D014786:Vision Disorders / Q000150:complications* / Q000175:diagnosis*; D014787:Vision Tests / Q000379:methods*; D014792:Visual Acuity