Vision Impairment As A Prognosis Of Dementia, Functional Hierarchy Scale, Communication And Death Using Interrai

To provide an analysis of data collected via an administered standardized assessment to describe the associations between vision impairment and dementia, functional and communication limitations and death in a cohort of frail older persons with vision impairment. 

University Hospital

Using interRAI data from 2016–2020 Home Care assessments, 13 health outcomes were investigated. Logistic regression, with cluster robust standard errors to accommodate multiple assessments, was used to assess associations between visual impairment and dementia, functional life limitations and death adjusting for age, gender, and diabetes. Models were estimated overall and stratified to assess the potential effects of residual confounding. The functional hierarchy score is a scale from  (0=independent – 11=dependent). 

Analyses used 469,817 assessments involving 141,445 people aged 65+. Dementia: 37% of people with adequate vision presented dementia that increases as the difficulties rise. The situation is critical when there is severe difficulty, increasing the dementia up to 55%. Functional hierarchy median limitations scores were: adequate vision 4 (4); minimal 5 (4), moderate 5 (4), and severe difficulty 7 (4); and no vision 7 (4). The limitations in daily life and communication are more important in people with lower vision, and this is progressively and more important in severe and no vision. Vision impairment is a prognostic factor related to death. 

In conclusion, while causal statements cannot be definitive, the findings illuminate associations between visual impairment and dementia, functional and communication limitations and death in older individuals. The extensive analysis, based on 469,817 assessments, revealed relationships adjusted for age, gender, and diabetes. Further investigation is warranted to explore the potential effects of residual confounding. These insights highlight the importance of ongoing research and interventions addressing vision impairment and dementia. Cataract is the main cause of vision loss in this population, and addressing surgery on time is critical.