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Memory Deficit Associated with Worse Functional Trajectories in Older Adults in Low-Vision Rehabilitation for Macular Disease

Authors

  • Heather E. Whitson MD, MHS,

    Corresponding author
    1. Department of Medicine, Duke University, Durham, North Carolina
    2. Department of Ophthalmology, Duke University, Durham, North Carolina
    3. Geriatric Research, Education and Clinical Center, Durham Veterans Affairs Medical Center, Durham, North Carolina
    • Aging Center, Duke University, Durham, North Carolina
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  • Diane Whitaker OD,

    1. Department of Ophthalmology, Duke University, Durham, North Carolina
    2. Eye Center, Duke University, Durham, North Carolina
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  • Linda L. Sanders MPH,

    1. Department of Medicine, Duke University, Durham, North Carolina
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  • Guy G. Potter PhD,

    1. Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina
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  • Scott W. Cousins MD,

    1. Department of Ophthalmology, Duke University, Durham, North Carolina
    2. Eye Center, Duke University, Durham, North Carolina
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  • Deidra Ansah MD,

    1. Grady Health System, Emory School of Medicine, Atlanta, Georgia
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  • Eleanor McConnell RN, PhD,

    1. Aging Center, Duke University, Durham, North Carolina
    2. School of Nursing, Duke University, Durham, North Carolina
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  • Carl F. Pieper DrPh,

    1. Aging Center, Duke University, Durham, North Carolina
    2. Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
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  • Lawrence Landerman PhD,

    1. Aging Center, Duke University, Durham, North Carolina
    2. Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina
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  • David C. Steffens MD,

    1. Aging Center, Duke University, Durham, North Carolina
    2. Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina
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  • Harvey J. Cohen MD

    1. Aging Center, Duke University, Durham, North Carolina
    2. Department of Medicine, Duke University, Durham, North Carolina
    3. Geriatric Research, Education and Clinical Center, Durham Veterans Affairs Medical Center, Durham, North Carolina
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Address correspondence to Dr. Heather Whitson, Aging Center, Duke University, DUMC 3003, Durham, NC 27710. E-mail: heather.whitson@duke.edu

Abstract

Objectives

To examine whether performance on a brief memory test is related to functional outcomes in older individuals undergoing low-vision rehabilitation (LVR) for macular disease.

Design

Observational cohort study of individuals receiving outpatient LVR.

Setting

Academic center.

Participants

Ninety-one individuals (average age 80.1) with macular disease.

Measurements

Memory was assessed at baseline using a 10-word list; memory deficit was defined as immediate recall of two or fewer words. Vision-related function was measured using the 25-item Visual Function Questionnaire (VFQ-25) administered at baseline and during subsequent interviews (mean follow-up, 115 days). Linear mixed models were constructed to compare average trajectories of four VFQ-25 subscales: near activities, distance activities, dependency, and role difficulty.

Results

The 29.7% of participants with memory deficits tended to decline in ability to accomplish activities that involved near vision. Controlling for age, sex, and education, the functional trajectory of participants with memory deficit differed significantly from that of those with better memory (P = .002), who tended to report improvements in ability to accomplish near activities.

Conclusion

Of older adults receiving LVR for macular disease, those with memory deficits experienced worse functional trajectories in their ability to perform specific visually mediated tasks. A brief memory screen may help explain variability in rehabilitation outcomes and identify individuals who might require special accommodations.

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