title: Impact of visual impairment on vision-specific quality of life among older adults living in nursing home.
abstract: BACKGROUND
  Visual impairment (VI) has a significant negative impact on quality of life (QoL) amongst older people living in nursing homes. The purpose of this study was to determine the prevalence of VI and blindness and to explore the association between severity of VI and vision-specific QoL among older people living in nursing homes of Kathmandu, Nepal.
  
  
  METHODS
  This cross-sectional study involved 158 residents aged 60 years or older residing in seven nursing homes of Kathmandu Valley, Nepal. Near acuity, presenting and the best corrected distance visual acuity (VA) were assessed in each eye and considered in the better eye after adequate refraction. A complete anterior and posterior segment examination was carried out. Face-to-face interviews were conducted using a 57-item Nursing Home Vision-Targeted Health-Related Quality of Life (NHVQoL) questionnaire.
  
  
  RESULTS
  The mean age of residents was 75.60 ± 7.12 years and the majority were female (66.46%). The prevalence of VI and blindness was 45.57% and its leading cause was cataract, which was followed by age-related macular degeneration, corneal opacity, glaucoma and macular scar. The mean composite score of NHVQoL questionnaire was 52.22 ± 12.49. There was a consistent overall deterioration in the mean composite score as well as each subscale score of NHVQoL questionnaire with a worsening of VA.
  
  
  CONCLUSIONS
  VI and blindness are highly prevalent among older people living in nursing homes. VI has a significant negative impact on vision-specific QoL. Vision-specific QoL is reduced, and the reduction in the QoL bears a positive association with severity of VI among older people living in nursing homes.
authors.affiliation: Department of Ophthalmology, B. P. Koirala Lions Center for Ophthalmic Studies, Institute of Medicine, Tribhuvan University , Maharajgunj, Kathmandu , Nepal .
authors.forename: Mahesh Kumar
authors.initials: MK
authors.lastname: Dev
authors.forename: Nabin
authors.initials: N
authors.lastname: Paudel
authors.forename: Niraj Dev
authors.initials: ND
authors.lastname: Joshi
authors.forename: Dev Narayan
authors.initials: DN
authors.lastname: Shah
authors.forename: Shishir
authors.initials: S
authors.lastname: Subba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000453:epidemiology / Q000523:psychology*; D002386:Cataract / Q000453:epidemiology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D009735:Nursing Homes; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D014787:Vision Tests; D015354:Vision, Low / Q000453:epidemiology / Q000523:psychology*; D014792:Visual Acuity