Visual impairment and blindness in institutionalized elderly in Germany
- 70 Downloads
To determine the prevalence of and identify factors associated with visual impairment and blindness in institutionalized elderly in Germany.
In this prospective multicenter cross-sectional study, ophthalmic health care need and provision were investigated in institutionalized elderly in 32 nursing homes in Germany. All participants underwent a standardized examination including medical and ocular history, refraction, visual acuity testing, tonometry, biomicroscopy, and dilated funduscopy. A standardized questionnaire was used to identify factors associated with eye healthcare utilization, visual impairment and/or blindness.
Visual acuity of 566 (94.3%; 413 women and 153 men) of a total of 600 institutionalized elderly was determined. Mean age of the included patients was 82.9 years (± 9.8). Of all participants, 30 (5.3%; 95% CI 3.4–7.2%) were blind and 106 (18.7%; 95% CI 15.5–21.9%) were moderately or severely visually impaired according to the World Health Organization definition. The 136 blind and moderately or severely visually impaired participants were older (OR, Odds Ratio = 1.1, 95% CI 1.0–1.1; p < 0.001), and more likely to have reduced mobility (OR = 12.6, 95% CI 2.8–57.6; p = 0.001).
A high proportion of blindness and visual impairment was found amongst nursing home residents. Age and reduced mobility were factors associated with an increased likelihood of blindness and visual impairment. Any surveys of blindness and visual impairment excluding nursing homes may considerably underestimate the prevalence of visual impairment and blindness.
KeywordsAging Low vision Visual loss Blindness Nursing homes
This study was supported by the Ernst und Bertha Grimmke Foundation, Germany (PPL and TUK).
The Department of Ophthalmology, University of Bonn, received research funding from the Stiftung Auge (German Eye Foundation) of the German Ophthalmological Society (DOG) with support of Bayer and Novartis for the OVIS study. The Medical Biometry and Epidemiology Unit of Witten/Herdecke University received research funding from the University of Bonn (Eye Hospital) for the methodological counseling of this investigation.
Compliance with ethical standards
Disclosure of potential conflicts of interest
S. Thiele reports personal fees from Carl Zeiss MediTec, Heidelberg Engineering, and Optos, outside the submitted work. T. U. Krohne reports personal fees from Alimera Sciences, Bayer, Heidelberg Engineering, and Novartis, outside the submitted work. F. Ziemssen has received honoraria for consultation and research from Alimera, Allergan, Bayer, Biogen, MSD, Novartis, NovoNordisk and Roche, none was related to the topic. F.G. Holz reports personal fees from Acucela, Allergan, Bayer, Bioeq, Boehringer Ingelheim, Carl Zeiss MediTec, Genentech/Roche, Heidelberg Engineering, Merz, NightstarX, Novartis, Optos, Pixium and Thea, outside the submitted work. R. P. Finger reports personal fees from Bayer, Opthea, Santen, Novartis, Retina Implant and Novelion, outside the submitted work.
None of the sponsors had any role in the study design; in the collection, analysis and interpretation of the data; in the writing of the report; and in the decision to submit the paper for publication. None of the authors has any proprietary or competing interests to disclose.
Research involving human participants
All procedures performed in studies involving human participants were in accordance with the ethical standards of the local ethic committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants or their legal guardians included in the study.
- 1.Bourne RRA, Flaxman SR, Braithwaite T et al (2017) Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis. Lancet Glob Health 5(9):e888–e897. https://doi.org/10.1016/S2214-109X(17)30293-0 CrossRefGoogle Scholar
- 4.Mitchell P, Hayes P, Wang JJ (1997) Visual impairment in nursing home residents: the Blue Mountains Eye Study. Med J Aust 166(2):73–76Google Scholar
- 12.Bowen M, Edgar DF, Hancock B et al (2016) The prevalence of visual impairment in people with dementia (the PrOVIDe study): a cross-sectional study of people aged 60–89 years with dementia and qualitative exploration of individual, carer and professional perspectives. Heal Serv Deliv Res 4(21):1–200. https://doi.org/10.3310/hsdr04210 CrossRefGoogle Scholar
- 14.Wolfram C, Pfeiffer N (2012) Weißbuch zur Situation der ophthalmologischen Versorgung in Deutschland. DOG Deutsche Ophthalmologische Gesellschaft, MünchenGoogle Scholar
- 18.World Health Organization (2016) ICD-10 Version: 2016. http://apps.who.int/classifications/icd10/browse/2016/en#!/H53-H54. Accessed 9 May 2018