关键词:  , 视力损伤, 日常生活活动能力, 老年人

Abstract:  Objective To evaluate the impact of visual impairment on activities of daily living (ADL) in the hospitalized elderly patients. Design Cross-sectional study. Participants 123 patients aged 60 years and older, hospitalized in the Department of Gerontology from January to December in 2019 were recruited. Methods General information including age, gender, education, reading habits and accompanying diseases were recorded by questionnaire. According to the living habits of patients, the living distant and near vision acuity were measured. The distance vision acuity ≤0.63 was classified as distant vision impairment, and the near vision acuity <0.5 was classified as near vision impairment. Reading visual acuity was measured using Chinese reading visual acuity chart. Basic activities of daily living (BADL) and instrumental activities of daily living（IADL） were evaluated with Barthel index scale and Lawton's scale separately. The evaluation of each activity in the scale was divided into "need help" and "completely independent". One of activity in the scale was rated as "need help", which was defined as BADL limitation or IADL limitation. Logistic regression model was used for multivariate analysis. Main Outcome Measures Distant visual acuity, near visual acuity, reading acuity, Barthel index scale, Lawton's scale. Results There were 56 patients (45.5%) with distant visual impairment and 24 patients (19.5%) with near visual impairment in the 123 patients. 50 patients (40.7%) with limitation in BADL and 44 patients (35.8%) with limitation in IADL. 31 patients (55.4%) with distant vision impairment had limitation in BADL and 27 patients (48.2%) in IADL, which showed statistically significant differences with patients without distance vision impairment (x2=8.131，P=0.004; x2=5.968，P=0.015). 19 patients (79.2%) with near vision impairment had limitation in BADL and 17 patients (70.8%) in IADL, which showed statistically significant differences with patients without near vision impairment (x2=16.405，P＜0.001; x2=13.842, P＜0.001). Limitation in BADL was found associated with near visual acuity (OR=1.73, 95%CI: 1.24~2.43, P＜0.001), age (OR=1.24, 95%CI: 1.14~1.35, P＜0.001), education(OR=0.18, 95%CI: 0.05~0.69, P=0.013). Both near visual acuity and education were protective factors for BADL. Similarly, limitation in IADL was found associated with reading visual acuity(OR=1.69, 95%CI: 1.22~2.34, P=0.002), age (OR=1.15, 95%CI: 1.07~1.24, P＜0.001), cancer (OR=3.59, 95%CI: 1.12~11.54, P=0.032), experience of fall (OR=2.98, 95%CI: 1.11~8.02, P=0.031). Good reading visual acuity was the only protective factor found. Age was the risk factor for both limitation in BADL and IADL. Conclusion Visual impairment was the risk factor of limited ADL in the hospitalized elderly patients. (Ophthalmol CHN, 2024, 33: 132-137)

Key words:  , visual impairment, activities of daily living, elderly