Judith Renaud

Participation in daily activities and social roles of older adults with visual impairment

Purpose. (1) to document participation in daily activities and social roles of older adults seeking services for visual impairment (VI) and compare it with that of the older population without VI or other disabilities, and (2) to explore correlates of their participation. Methods. The 64 participants (46 women) had an average age of 79.3 years (SD = 5.9 years) and presented various types of VI. Participants were interviewed at home to collect information regarding their visual function (National Eye Institute Visual Function Questionnaire-25), sociodemographic and clinical characteristics, including depressive symptoms (Geriatric Depression Scale), and participation (Assessment of Life Habits/LIFE-H). Each participant was matched with another person without disabilities randomly recruited from the community. Results for the two populations on the Life-H participation domains were compared using t-tests. In the group with VI, general information (independent variables) was examined in relation to participation main scores (dependent variables), followed by multiple linear regression analyses. Results. Participation in daily activities and social roles of participants with VI (mean ± SD (/9) = 6.8 ± 1.0 and 5.6 ± 1.6, respectively) was significantly lower than that of participants without VI (8.1 ± 0.4 and 8.3 ± 0.4) (p < 0.0001). Depressive symptoms and perceived quality of distance vision were the strongest correlates and together explained more than 65% of the variance in the participation scores of the subjects with VI. Conclusions. This study demonstrates the participation restrictions associated with VI and underlines the importance of psychological aspects in participation.

Health-related and subjective quality of life of older adults with visual impairment

Purpose. To document health-related quality of life (HRQOL) and subjective quality of life (SQOL) and explore their correlates in older adults seeking services for visual impairment (VI). Method. A convenience sample of 64 participants (79.3 ± 5.9 years) with VI was interviewed at home. HRQOL was measured with the Visual Function Questionnaire-25 and SQOL with the Quality of Life Index. The potential correlates were as follows: personal factors (sociodemographic characteristics, co-morbidity, depressive symptoms, activity level), environmental factors (technical aids, social support) and participation in daily activities and social roles (level and satisfaction). Results. Compared to normative data from previous studies of older adults, the participants had lower HRQOL but similar SQOL. Greater level of participation in social roles, higher perceived activity level, use of a writing aid and greater satisfaction with participation in social roles together explained better HRQOL (R2 = 0.66). Fewer depressive symptoms, greater satisfaction with participation in social roles and with social support and fewer co-morbidities together explained better SQOL (R2 = 0.70). Conclusions. HRQOL of older adults with VI is mainly explained by level of participation correlates, while their SQOL is mainly explained by depressive symptoms and satisfaction variables. The results also underscore the importance of social roles for HRQOL and SQOL of this population.

Depression in the elderly with visual impairment and its association with quality of life

Background Visual impairment is more prevalent in the elderly and depression is common in this population. Although many studies have investigated depression or quality of life (QOL) in older adults with visual impairment, few have looked at the association between these two concepts for this population. The aim of this systematized review was to describe the association between depression and QOL in older adults with visual impairment. Methods A search was done using multiple electronic databases for studies addressing the relationship between QOL and depression in elders with visual impairment. The concept of QOL was divided into two different approaches, ie, QOL as achievement and QOL as subjective well-being. Comparison of QOL scores between participants with and without depression (Cohen’s d) and correlations between depression and QOL (Pearson’s r) were examined. Results Thirteen studies reported in 18 articles were included in the review. Nearly all of the studies revealed that better QOL was moderately to strongly correlated with less severe depressive symptoms (r = 0.22–0.68 for QOL as achievement; r = 0.68 and 0.72 for QOL as subjective well-being). Effect sizes for the QOL differences between the groups with and without depression ranged from small to large (d = 0.17 to 0.95 for QOL as achievement; no data for QOL as subjective well-being). Conclusion Additional studies are necessary to pinpoint further the determinants and mediators of this relationship. Considering the high prevalence rate of depression in this community and its disabling effects on QOL, interventions to prevent and treat depression are essential. More efforts are needed in clinical settings to train health care practitioners to identify depressed elders with visual impairment and provide appropriate treatment.

Contrast sensitivity, healthy aging and noise

At least three studies have used external noise paradigms to investigate the cause of contrast sensitivity losses due to healthy aging. These studies have used noise that was spatiotemporally localized on the target. Yet, Allard and Cavanagh (2011) have recently shown that the processing strategy can change with localized noise thereby violating the noise-invariant processing assumption and compromising the application of external noise paradigms. The present study reassessed the cause of age-related contrast sensitivity losses using spatiotemporally extended external noise (i.e., full-screen, continuously displayed dynamic noise). Contrast thresholds were measured for young (mean=24 years) and older adults (mean=69 years) at 3 spatial frequencies (1, 3 and 9 cpd) and 3 noise conditions (noise-free, local noise and extended noise). At the two highest spatial frequencies, the results were similar with local and extended noise: the sensitivity loss was mainly due to lower calculation efficiency. At the lowest spatial frequency, age-related contrast sensitivity losses were attributed to the internal equivalent noise when using extended noise and, like in previous studies, due to calculation efficiency with local noise. These results show that the interpretation of external noise paradigms can drastically differ depending on the noise type suggesting that external nose paradigms should use external noise that is spatiotemporally extended like internal noise to avoid triggering a processing strategy change. Contrary to previous studies, we conclude that healthy aging does not affect the calculation efficiency of the detection process at low spatial frequencies.

Awareness Tool for Safe and Responsible Driving (OSCAR): A Potential Educational Intervention for Increasing Interest, Openness and Knowledge About the Abilities Required and Compensatory Strategies Among Older Drivers

Objective: This pilot study aimed to verify the impact of the awareness tool for safe and responsible driving (OSCAR) on older adults’ (1) interest, openness, and knowledge about the abilities and compensatory strategies required for safe driving; (2) awareness of changes that have occurred in their own driving abilities; and (3) actual utilization of compensatory strategies. Methods: A preexperimental design, including a pretest (T0) and posttest (T1) 8 to 10 weeks after exposure to the intervention, was used with 48 drivers aged between 67 and 84. The participants had a valid driving license and drove at least once a week. Results: Overall, the results demonstrate that OSCAR increased interest, openness, and knowledge about the abilities and compensatory strategies of older drivers (P <.01). After exposure to OSCAR, the majority of the participants confirmed that changes had occurred in at least one of their abilities. Moreover, half of the older drivers reported having started using 6 or more compensatory strategies. Conclusion: In summary, in addition to increasing older adults’ interest, openness, and knowledge to discussion about driving, OSCAR also improved awareness of the changes that could negatively impact safe driving and enhanced utilization of compensatory strategies. While promoting safe driving and the prevention of crashes and injuries, this intervention could ultimately help older adults maintain or increase their transportation mobility. More studies are needed to further evaluate OSCAR and identify ways to improve its effectiveness.

Outil de sensibilisation des conducteurs âgés aux capacités requises pour une conduite automobile sécuritaire et responsable (OSCAR) : développement et validation

L’objectif de cette etude etait de developper et de valider un outil d’intervention pour sensibiliser les conducteurs âges aux capacites requises et aux strategies compensatoires pour une conduite automobile securitaire. Une recension elargie des ecrits a d’abord ete realisee pour developper l’Outil de Sensibilisation des conducteurs âges aux capacites requises et aux strategies compensatoires pour une conduite automobile securitaire et responsable (OSCAR). L’outil comprend une serie de 15 questions et 15 capsules educatives en lien avec le vieillissement et la conduite automobile. Un dispositif experimental incluant un pre-test et un post-test huit a dix semaines apres l’intervention a ensuite ete utilise aupres de 48 personnes âgees entre 67 et 84 ans qui conduisaient au moins une fois par semaine. A la suite de la passation de l’OSCAR, les resultats demontrent que l’interet, l’ouverture et les connaissances des aines sur les capacites requises et les strategies compensatoires ont augmente de facon significative (p