title: Alteration of travel patterns with vision loss from glaucoma and macular degeneration.
abstract: OBJECTIVE
  The distance patients can travel outside the home influences how much of the world they can sample and to what extent they can live independently. Recent technological advances have allowed travel outside the home to be directly measured in patients' real-world routines.
  
  
  OBJECTIVE
  To determine whether decreased visual acuity (VA) from age-related macular degeneration (AMD) and visual field (VF) loss from glaucoma are associated with restricted travel patterns in older adults.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Patients were recruited from an eye clinic, while travel patterns were recorded during their real-world routines using a cellular tracking device.
  
  
  METHODS
  Sixty-one control subjects with normal vision, 84 subjects with glaucoma with bilateral VF loss, and 65 subjects with AMD with bilateral or severe unilateral loss of VA had their location tracked every 15 minutes between 7 am and 11 pm for 7 days using a tracking device.
  
  
  METHODS
  Average daily excursion size (defined as maximum distance away from home) and average daily excursion span (defined as maximum span of travel) were defined for each individual. The effects of vision loss on travel patterns were evaluated after controlling for individual and geographic factors.
  
  
  RESULTS
  In multivariable models comparing subjects with AMD and control subjects, average excursion size and span decreased by approximately one-quarter mile for each line of better-eye VA loss (P ≤ .03 for both). Similar but not statistically significant associations were observed between average daily excursion size and span for severity of better-eye VF loss in subjects with glaucoma and control subjects. Being married or living with someone and younger age were associated with more distant travel, while less-distant travel was noted for older individuals, African Americans, and those living in more densely populated regions.
  
  
  CONCLUSIONS
  Age-related macular degeneration-related loss of VA, but not glaucoma-related loss of VF, is associated with restriction of travel to more nearby locations. This constriction of life space may impact quality of life and restrict access to services.
authors.affiliation: Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland2Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
authors.forename: Frank C
authors.initials: FC
authors.lastname: Curriero
authors.forename: Jessie
authors.initials: J
authors.lastname: Pinchoff
authors.forename: Suzanne W
authors.initials: SW
authors.lastname: van Landingham
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferrucci
authors.forename: David S
authors.initials: DS
authors.lastname: Friedman
authors.forename: Pradeep Y
authors.initials: PY
authors.lastname: Ramulu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005901:Glaucoma / Q000503:physiopathology*; D006801:Humans; D008268:Macular Degeneration / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014195:Travel / Q000706:statistics & numerical data*; D015354:Vision, Low / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology
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